Electronic Patient-Reported Outcome Monitoring With Alert-Based Interventions in Metastatic Breast Cancer: A
Maria M Karsten1, Pimrapat Gebert2,3, Therese Pross1
1Department of Gynecology with Breast Center, Charité-Universitätsmedizin Berlin, Berlin, Germany.
JAMA Oncology
|August 6, 2026
Summary
Digital patient-reported outcome monitoring significantly reduced fatigue and improved physical functioning in patients with metastatic breast cancer. This approach shows promise for integration into routine oncology care.
Area of Science:
- Oncology
- Digital Health
- Patient-Reported Outcomes
Background:
- Electronic patient-reported outcome (PRO) monitoring shows benefits in advanced cancer, but data for metastatic breast cancer (mBC) are limited.
- Fatigue is a prevalent and impairing symptom in mBC, making it a key target for PRO monitoring.
Purpose of the Study:
- To evaluate if digital PRO monitoring with alert-based responses can reduce fatigue in patients with mBC.
Main Methods:
- A multicenter randomized clinical trial involving women with mBC receiving systemic therapy.
- Intervention group: weekly smartphone-based PRO questionnaires with automated alerts for deterioration.
- Control group: usual care with quarterly PRO questionnaires and no alerts.
Main Results:
- At 6 months, the intervention group showed a clinically meaningful reduction in fatigue (mean difference of -5.4 points) compared to the control group.
- Physical functioning was significantly improved in the intervention group (mean difference of 4.0 points).
- Quality of life improvements were observed but did not reach the minimal clinically important difference.
Conclusions:
- Digital PRO monitoring with alert-based responses is associated with significant reductions in fatigue and improvements in physical functioning for mBC patients.
- These findings support the integration of alert-based PRO monitoring into standard oncology care.