Web-mediated follow-up via patient-reported outcomes vs. routine surveillance in lung cancer patients

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Published: 2 Jun 2018
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Dr Fabrice Denis - Jean Bernard Centre, Le Mans, France

Dr Denis speaks with ecancer at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting about the final results from a randomised trial comparing a web-mediated follow-up via patient-reported outcomes vs. routine surveillance in lung cancer patients.

He goes on to state that with a longer follow-up and although eligible patients from the control arm crossed over to receive intervention after the preplanned interim analysis, the overall survival remained significantly larger with the web-mediated follow-up based on patient-reported outcomes than with routine disease follow-up by CT scans alone.

 

I presented yesterday our final results of survival concerning the phase III randomised trial comparing web-mediated follow-up with an application called MoovCare for lung cancer patients and it was compared to routine surveillance by CT scan. In this multi-centric trial we already showed two years ago interim results that showed survival benefits by 7 months and we confirmed this result by final analysis and longer follow-up. We have now two years follow-up and we confirmed the same survival benefit although we performed a crossover of patients after interim analysis, of patients from control to experimental arm because the magnitude of benefit was too high to continue inclusion of this trial.

Did they see the same benefit post-crossover?

That’s it, yes. The benefit is maintained and so the application will be progressively tested in a pilot study in the USA and in Europe and afterwards it will be reimbursed in France first and in Europe afterwards. We think that it could be spread in interested centres next year.

A lot of the conversations we have at these conferences are about mechanisms of action and pharmacodynamics. Has anyone tried to understand the mechanism of action here?

This application allowed to detect relevant events such as relapse or complication of treatment earlier than routine follow-up. We found that patients with a relapse had higher performance status at the moment of relapse detection using this application as contrary to CT scan surveillance for which patients are often waiting two, three or four weeks, having their CT scan to see their physician. So when we detect relapse earlier we can treat it earlier too.

This application also allows us to perform earlier supportive care. So if you make the combination of early supportive care, early treatment of recurrence you can obtain survival benefit.

Like you say, the next step from here will be the trials.

The next step is to build a wide application for all cancer at any stage for any treatment and we are working for that with Ethan Basch who published last year a large controlled randomised trial on patient reported outcome during chemotherapy. So we will initiate this trial at the end of this year and we think we would be able to spread this application in two years.