CN3 - Patient adherence to digital patient-reported outcome monitoring (PROM) in cancer immunotherapies

Background

PROM platforms, characterized by systematic collection of symptoms and quality of life data, enable timely reactions of health care professionals (HCPs) in trial and routine care settings. The “KAIKU” platform provides a novel algorithm-based approach of converting PROM into safety alerts enabling severity-driven communication between patients and HCPs. In KAIKU’s immunotherapy module, patients are interviewed weekly of potential immune-related adverse events. In this study, we investigated if patient adherence to digital PROM is impacted by parameters such as symptom burden, health status, patient characteristics, or device.

Methods

Pooled analyses were performed of retrospective data from six digital PROM pilots in immunotherapies. The study included 243 patients from 6 countries: NO (97), FI (56), NL (37), DE (26), CH (17), and IT (10). Following parameters were analyzed: weekly adherence to questionnaires in correlation to symptom burden, health status (QLQ-C30), age, sex, device (app, browser), messaging, and country for 12-week period.

Results

Mean weekly adherence to PROM on all devices was 80%, ranging from 72.3% (IT) to 84% (FI). Experienced symptom burden (r=-0.46), fatigue level (r=-0.32), physical condition (r=-0.23) or global health status (r= 0.22) did not correlate with adherence. There were no differences between females (79.9%) and males (80.1%) but both had higher adherence using app compared to browser. KAIKU enabled communication with HCPs, but patients’ messaging activity did not correlate with adherence (r=0.13). In all age groups, both app and browser-based platform were used. Adherence was highest for ages 60-69. Younger patients (40-59) had a considerable adherence drop when using the desktop browser, whereas in ages 60-89 there weren’t such differences between devices.

Conclusions

Digital PROM in cancer patients receiving immunotherapies results in high adherence regardless of country, age, sex, user activity or disease burden, implying it is clinically feasible, and patients stay adherent both in good and worsening health conditions. High adherence to app-based platform across all ages indicates that app-based PROM should be preferred over other methods.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

S.M.E. Livanainen: Financial Interests, Personal, Advisory Board: MSD, Bristol Myers Squibb, Novartis, Roche; Financial Interests, Institutional, Local PI: Bristol Myers Squibb, Faron; Financial Interests, Institutional, Research Grant: AstraZeneca, Roche; Financial Interests, Institutional, Other, Sub-investigator: MSD; Financial Interests, Personal and Institutional, Steering Committee Member, The Origama study: Roche; Financial Interests, Institutional, Other, Sub-Investigator (The ECHO Trial): Kaiku Health; Other, Study Steering committee member: Hoffman-La Roche. P. Mohr: Financial Interests, Personal, Advisory Board: Bristol Myers Squibb, Merck Sharp & Dohme, Merck Sharp & Dohme, Novartis, GSK, Pierre Fabre, Sanofi; Financial Interests, Personal, Invited Speaker: Amgen, Bristol Myers Squibb, Merck Sharp & Dohme, Merck Sharp & Dohme, Novartis, Roche, Pierre Fabre, Sanofi, Sun Pharma; Financial Interests, Institutional, Funding: Bristol Myers Squibb, Merck Sharp & Dohme, Novartis; Non-Financial Interests, Principal Investigator: Bristol Myers Squibb, Merck Sharp & Dohme, Regeneron, Sanofi, Novartis, Sun Pharma. A. Addeo: Financial Interests, Institutional, Advisory Board: Bristol Myers Squibb, AZD, Roche, Eli Lilly; Financial Interests, Personal, Advisory Board: Pfizer, Takeda, MSD; Financial Interests, Institutional, Invited Speaker: Novartis. P.A. Ascierto: Financial Interests, Personal, Other, Consultant and Advisory Role: Bristol Myers Squibb, Roche Genentech, MSD, Novartis, Merck Serono, Pierre Fabre, AstraZeneca, Sun Pharma, Sanofi, Idera, Sandoz, Immunocore, 4SC, Nektar, Boehringer Ingelheim, Regeneron; Financial Interests, Personal, Other, Consultant and Advisory Role.Travel support: Pfizer/Array; Financial Interests, Personal, Other, Consultant Role: Italfarmaco; Financial Interests, Personal, Other, Advisory Role: Eisai, Seagen; Financial Interests, Personal, Other, Consultant Role: Daiichi Sankyo, Pfizer, Oncosec, Nouscom, Lunaphore; Financial Interests, Personal, Other, Consultant role: Medicenna; Financial Interests, Personal, Other, Consultant role and travel support: Bio-AI Health; Financial Interests, Personal, Advisory Board, Consultant and Advisory Role: iTeos; Financial Interests, Personal, Advisory Board, Consultant and Advisory role: ValoTx; Financial Interests, Personal, Advisory Board, Consultant and Advisor role. Travel support: Replimmune; Financial Interests, Personal, Advisory Board, Advisor role: Bayer; Financial Interests, Personal, Advisory Board: Erasca; Financial Interests, Institutional, Funding, Clinical trial and translational research: Bristol Myers Squibb; Financial Interests, Institutional, Funding, Clinical Trial: Roche Genentech, Pfizer/Array, Sanofi; Non-Financial Interests, Leadership Role, President since 2010: Fondazione Melanoma Onlus Italy; Non-Financial Interests, Leadership Role, President since 2014: Campania Society of ImmunoTherapy of Cancer (SCITO) Italy; Non-Financial Interests, Other, Member of Steering Committee since 2016: Society for Melanoma Research (SMR); Non-Financial Interests, Member of Board of Directors, November 2017 - December 2021: Society for Immunotherapy of Cancer (SITC); Non-Financial Interests, Member: ASCO, SITC, EORTC Melanoma Cooperative Group, AIOM, SMR. J.P. Koivunen: Financial Interests, Personal, Advisory Board: Merck Sharp Dome, Bristol Myers Squibb, AstraZeneca, Pfizer, Roche, Boehringer Ingelheim, Takeda, Amgen; Financial Interests, Personal, Full or part-time Employment: Faron Pharmaceuticals; Financial Interests, Personal, Stocks/Shares: Faron Pharmaceuticals; Financial Interests, Institutional, Funding: AstraZeneca; Financial Interests, Institutional, Coordinating PI: Boehringer Ingelheim, Roche. C.U. Blank: Financial Interests, Institutional, Advisory Board: Bristol Myers Squibb, MSD, Roche, Novartis, GSK, AZ, Pfizer, Lilly, GenMab, Pierre Fabre; Financial Interests, Personal, Advisory Board: Third Rock Ventures; Financial Interests, Personal, Stocks/Shares: Immagene; Financial Interests, Personal, Stocks/Shares, intention to develop IFN signature algorithm: NewCo; Financial Interests, Institutional, Coordinating PI: Bristol Myers Squibb, Novartis, NanoString, 4SC; Other, pending patent: WO 2021/177822 A1. All other authors have declared no conflicts of interest.