Wednesday, June 7, 2017

Metastatic cancer Patients live longer by using web-based tool

A web-based tool that enables metastatic cancer patients to report their symptoms in real time, giving alerts to clinicians, has been indicated to have major benefits, involving longer survival rates.

In a randomized clinical trial of 766 sufferers, those who used the tool to regularly self-report symptoms while getting chemotherapy lived a median of five months longer than those who didn’t use the tool. Results of the research were presented June 4 in the plenary session of the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

The research was led by Ethan Basch, MD, professor of medicine at the Lineberger Comprehensive Cancer Center of the University of North Carolina, who was practicing at Memorial Sloan Kettering Cancer Center in New York when the clinical trial was conducted.

“Online technologies have transformed communications in practically every aspect of our lives, and now we are seeing they are also allowing sufferers to take an active role in their care and get immediate access to their care provider,” claimed Basch. “The improvement in survival we saw might seem modest, but it is higher than the effect of several targeted cancer drugs for metastatic cancer patients.”

“When you consider about the cost of doing this, which is almost nil, versus the cost of drugs, it is pretty darn remarkable,” Eric Topol, MD, director of the Scripps Translational Science Institute, told the 2017 AHIP Institute & Expo this week in Austin, Texas.

The web-based tool, known as the Symptom Tracking and Reporting (STAR) system, was internally developed at Memorial Sloan Kettering Cancer Center for research purposes and isn’t commercially available.

“The aim of this research was really to see if you could use this web-based digital interface to allow sufferers to connect more readily to their medical team in the short term to see how that would impact quality of life and healthcare utilization,” claims ASCO expert Harold Burstein, MD.

“Sufferers and medical teams deployed these digital communications and when they did so saw they saw dramatic improvement in patient quality of life, a decrease in the numbers of times patients went to the emergency room, patients were capable to get more anti-cancer therapy that enabled treatment, as well as a better overall survival benefit,” adds Burstein. “People really lived longer with advanced cancer, and that is really quite an outstanding thing.”

Sufferers enrolled in the trial had advanced solid tumors—genitourinary, gynecologic, breast and lung— and were getting outpatient chemotherapy. The intervention group sufferers were randomly assigned to use tablet computers to report on 12 common symptoms experienced during chemotherapy, involving appetite loss, difficulty breathing, fatigue, hot flashes, nausea and pain, and to grade them on a five-point scale.

Sufferers could report their symptoms remotely from home or at the physician's office during oncology or chemotherapy visits, and nurses got email alerts when patients reported severe or worsening symptoms.

Compared with patients who got usual care, those who utilized the web tool to self-report symptoms had a longer median overall survival of 31.2 months versus 26 months.

“These were very dramatic outcomes, which is why they were engaged in the plenary session of our ASCO Annual Meeting last week,” analyzes Burstein. “The findings cut across all different kinds of cancers that affect all oncologists who work with cancer patients. It recommends that more intensive communication between the medical teams and the metastatic cancer patients can help nip issues in the bud.

“We require bringing easy-to-use communications between patients and medical teams into real, daily practice,” summarizes Burstein. “There are several companies making mobile apps, but this particular web interface was designed to immediately ping the nursing staff engaged with the patients’ care. So, you require systems that enable that kind of connectivity.”

A larger clinical trial is planned for community practices across the U.S. that will involve an updated, more user-friendly online tool that works on both personal computers and mobile devices.

 

No comments:

Post a Comment