Electronic symptom monitoring improves chemotherapy dose intensity in neoadjuvant chemotherapy for breast cancer

The present study investigated the clinical impact of electronic patient-reported outcome (ePRO) monitoring on chemotherapy dose intensities and adverse event (AE) management in patients with early-stage breast cancer receiving neoadjuvant chemotherapy.

In this single-center retrospective study, conducted between October 2022 and June 2024, we compared outcomes between patients treated with and without ePRO monitoring during neoadjuvant chemotherapy. The primary endpoint was the percentage of patients who achieved an average relative dose intensity (ARDI) of ≥85 %. The secondary endpoint was the persistence of grade ≥2 non-hematologic AEs, defined as symptoms that remained unresolved (i.e., not improved to grade ≤1) by the start of the subsequent chemotherapy cycle. Follow-ups continued until October 31, 2024.

Ninety-six patients were analyzed (ePRO group, n = 42; usual care group, n = 54). The percentage of patients achieving ARDI ≥85 % was significantly higher in the ePRO group than in the usual care group (85.7 % vs. 66.7 %, p = 0.029). The persistence of non-hematologic AEs was significantly lower in the ePRO group (p = 0.002). A multivariate analysis confirmed that ePRO use was independently associated with ARDI ≥85 % (odds ratio [OR], 4.05; 95 % confidence interval [CI], 1.04-15.8; p = 0.045) and reduced AE persistence (OR, 0.08; 95 % CI, 0.01-0.49; p = 0.002).

ePRO monitoring may help to maintain chemotherapy dose intensities and shorten the duration of AEs in early-stage breast cancer patients receiving neoadjuvant chemotherapy.