ePRO Symptom Follow-Up of Colorectal Cancer Patients Receiving Oxaliplatin-Based Adjuvant Chemotherapy is Feasible and Enhances the Quality of Patient Care: a prospective multicenter study

Abstract

Purpose: Electronic (e) patient reported outcomes (PROs) have been shown to improve the quality of life and survival in chemotherapy treated advanced cancer patients. We hypothesized that multidimensional ePRO centered approach could improve symptom management, streamline patient flow, and optimize the use of healthcare resources. Methods: In this multicenter trial (NCT04081558), colorectal cancer (CRC) patients receiving oxaliplatin-based chemotherapy as adjuvant or in the first or second line setting in advanced disease were included in the prospective ePRO cohort while a comparative retrospective cohort was collected from the same institutes. The investigated tool consisted of a weekly e-symptom questionnaire integrated to an urgency algorithm and laboratory value interface, which generated semi-automated decision support for chemotherapy cycle prescription, and individualized symptom management. Results: Recruitment to the ePRO cohort occurred 1/2019-1/2021 (n=43). The comparator group (n=194) consisted of patients treated in the same institutes 1-7/2017. The analysis was limited to adjuvant treated (n=36 and n=35). The feasibility of the ePRO follow-up was good with 98% reporting easy usage and 86% improved care, while health care personnel valued the easy use and logical workflow. In the ePRO cohort, 42% needed a phone call before planned chemotherapy cycles while this was 100% in the retrospective cohort (p=1.4e-8). Peripheral sensory neuropathy was detected significantly earlier with ePRO followed (p=1e-5) but did not translate to earlier dose reduction, delays, or unplanned therapy termination compared to the retrospective cohort. Conclusion: The results suggest that the investigated approach is feasible and streamlines workflow. Earlier symptom detection may improve the quality in cancer care.