Effectiveness of electronic patient-reported outcomes in patients with cancer undergoing immunotherapy: a real-world...

Immune checkpoint inhibitors (ICIs) are essential in advanced cancer treatments; however, they can cause severe immune-related adverse events (irAEs). Herein, we aimed to investigate the effectiveness of electronic patient-reported outcomes (ePROs) in monitoring the symptoms of patients with advanced cancer undergoing ICI therapy.

We retrospectively reviewed the medical records of patients with advanced cancer who received ICIs at the Komatsu Municipal Hospital between June 2019 and March 2024 following ePROs introduction.

Overall, 168 patients were included, with 43 and 125 in the ePRO and conventional care groups, respectively. The incidence of grade ≥ 3 irAEs was significantly lower in the ePRO than the conventional care group (7% vs. 21%; P = 0.039). Multivariate analysis showed that ePROs use was significantly associated with fewer emergency visits (odds ratio [OR]: 0.22, P < 0.001) and hospitalizations (OR: 0.36, P = 0.027). Patients in the ePRO group demonstrated significantly longer progression-free survival (PFS) and overall survival (OS) than did those in the conventional care group (median PFS: 10.8 vs. 4.8 months, hazard ratio [HR]: 0.50, P = 0.003; median OS: not reached vs. 17.0 months, HR: 0.40, P = 0.010). These survival benefits remained statistically significant after propensity score matching (n = 37 per group; PFS: HR 0.48, P = 0.009; OS: HR 0.37, P = 0.013).

Implementation of ePROs was associated with clinical benefits in patients with advanced cancer receiving ICI therapy. ePRO-based symptom monitoring may contribute to safer and more effective immunotherapy in real-world oncology practice.