Adherence to patient-reported outcome (PRO) monitoring among patients with lung cancer may be lower in the real world than in clinical trial settings, according to research published in JCO Oncology Practice.

Researchers observed a PRO adherence rate of roughly 50% in a real-world population, and this falls “well short of PRO adherence levels observed in seminal clinical trials, which have generally exceeded 70%.”

The researchers noted, however, that the results of this study may be unique to the study sites and may not be generalizable.

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The researchers reviewed PRO monitoring rates in 2019 for 1105 patients with lung cancer receiving cancer-directed systemic therapy. The study population comprised 56.2% women, the mean age was 65.8±10.2 years, 19.6% of patients were Black, 31.0% were receiving combination therapy, and 42.1% had stage IIIB-IV disease.

Patients were cared for at the University of Pennsylvania (site B; 73.2%) or 2 community-based centers: site A (8.9%) and site C (17.9%).

The patient-level adherence to PRO monitoring was 49.4% overall. It was highest at site C (70.0%), followed by site B (47.1%) and site A (27.2%). The encounter-level adherence to PRO monitoring was 55.4% overall and followed a similar pattern as the patient-level adherence rates.

Across all sites, patients aged 65 years and older, Black patients, or those with unknown stage of disease were less likely than their counterparts to adhere to PRO monitoring.

“Across this real-world cohort of patients undergoing treatment for lung cancer, adherence to PRO monitoring lagged that achieved in seminal clinical trials, with potential age- and race-based disparities, demonstrating an implementation gap that could be addressed with standardized reporting of an adherence-based quality metric,” the researchers wrote.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Takvorian SU, Anderson RT, Gabriel PE, et al. Real-world adherence to patient-reported outcome monitoring as a cancer care quality metric. JCO Oncol Pract. 2022;18(9):e1454-e1465. doi:10.1200/OP.21.00855

This article originally appeared on Oncology Nurse Advisor