Web Application Improves Survival in Advanced Lung Cancer

CHICAGO — A Web application called Moovcare that guides follow-up improved survival for patients with advanced lung cancer after receiving initial therapy, according to findings presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting.¹

“Why should we use a Web app in lung cancer?” said lead investigator Fabrice Denis, MD, PhD, a researcher at the Institut Inter-regional de Cancérologie Jean Bernard in Le Mans, France. “Lung cancer causes 1 million deaths per year worldwide; there is no standard follow-up; relapse does not occur during the planned visit; and relapsing patients often wait many weeks with symptoms before their visit.”

Therefore, researchers sought to evaluate the impact of a Web-mediated follow-up application on outcomes in patients with advanced lung cancer. For the multicenter, phase 3 study, investigators enrolled 133 patients with stage III or IV lung cancer who had completed initial chemotherapy, radiotherapy, or surgery. Patients were randomly assigned 1:1 to receive standard follow-up care, which included physician visits and CT scans every 3 to 6 months depending on physician discretion, or to use the Web application with the same frequency of physician visits but fewer scheduled CT scans.

Patients used the Web application to self-assess symptoms weekly, and caregivers could enter data on behalf of the patient. The application then analyzed 12 symptoms and reported those results to the patient’s oncologist. The Web application evaluated changes in symptoms and triggered email alters for the clinician who would then determine adaptations to cancer care, including the initiation of supportive care.

At 1 year, 75% of patients in the Web application arm were still alive compared with 49% of those in the standard follow-up arm (HR, 0.325; 95% CI, 0.157-0.672; P=.0025), researchers reported. Median overall survival was 19 months vs 12 months, respectively.

“The Web application allowed earlier detection of relapse,” Dr Denis added; however, relapse rates were similar between the 2 arms.

The Web application was also associated with 50% reduction in CT imaging per patient per year and overall quality of life was better in the Web application group.

“Through personalized follow-up using this convenient and simple online application, we can detect complications and signs of relapse and offer appropriate care earlier,” said Dr Denis. “This approach introduces a new era of follow-up in which patients can give and receive continuous feedback between visits to their oncologist.”

Reference

1. Denis F, Lethrosne C, Pourel N, et al. Overall survival in patients with lung cancer using a web-application-guided follow-up compared to standard modalities: Results of phase III randomized trial. J Clin Oncol. 2016; 34 (suppl; abstr LBA9006).