1837P - Assessing care complexity in remote patient monitoring (RPM): A cohort study of 2434 cancer patients across 50 sites in France and Belgium

Background

Remote patient monitoring (RPM) with ePROs improved morbidity and quality of life in cancer patients, as confirmed by multiple phase 3 trials. ESMO's clinical practice guidelines endorse RPM in routine care. Yet, factors linked with care complexity in RPM cancer patients remain largely unknown.

Methods

The Resilience PRO RPM process includes medical prescription, weekly symptom tracking (PRO-CTC-AE), and alerts to healthcare providers (HCP) for severe or worsening symptoms. Data from April 2022 to April 2024 for patients at 50 sites in France and Belgium was analyzed, focusing on demographics, tumor characteristics, treatment modalities, and social determinants of health (SDOH). Care complexity was evaluated by the alert rates, the number of alerts per questionnaire, and the HCP response time. Multivariate analysis identified key variables linked to increased care complexity.

Results

Among 2434 pts (median age 62 years; 73% female), the key tumor types were breast (52%), gastrointestinal (22%), genitourinary (9%), lung (7%) and gynecological (5%) cancers. 63% pts presented with non-metastatic disease. 58% pts reported at least 1 unfavorable SDOH: physically inactive (52%), current smoker (9%), financial insecurity (6.5%) and active alcohol consumption (5%). The time to response to the alert varied significantly across sites and HCPs, making it unreliable for assessing care complexity. The alert rate showed a high correlation (rho = 0.77, P<0.01) with the number of alerts per questionnaires and was chosen as the determinant of care complexity (primary endpoint). The multivariate analysis included age, gender, primary tumor type, treatment modality, metastatic status and SDOH. Three variables were significantly associated with higher alert rate: primary tumor type including head and neck, pancreas, sarcoma, esophageal and kidney; age > 80 years and financial insecurity.

Conclusions

Certain tumor types, older age > 80 yo, and financial insecurity are associated with higher alert rates and greater care complexity in RPM-monitored cancer patients. These factors should be considered when prescribing RPM to optimize resources and prioritize care for higher-risk patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Resilience Care.

Funding

Has not received any funding.

Disclosure

C. Baldini: Financial Interests, Institutional, Advisory Board: BMS, MSD; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Institutional, Research Grant: BMS; Financial Interests, Institutional, Coordinating PI: iTeos, Janssen, Seattle Genetics, Tahio, Pyramid Bioscience; Financial Interests, Institutional, Local PI: AZ, Amgen, Bicycle Therapeutics, MSD, Tango, Roche Genentech; Non-Financial Interests, Member: ASCO, SIOG, SOFOG, AACR, ESMO. T. Grellety: Financial Interests, Personal, Advisory Board: astrazeneca, pfizer, novartis, lilly, roche. E.G.C. Brain: Financial Interests, Personal, Invited Speaker, Webinars, optimized endocrine therapy for older breast cancer patients: Eli Lilly; Financial Interests, Personal, Advisory Board, Palbociclib and older breast cancer patients: Pfizer; Financial Interests, Personal, Invited Speaker, Symposium HER2+ MAO conference 03/21: Seagen; Financial Interests, Personal, Invited Speaker, ELEVATE 10/2021 and ABC 11/2021 meeetings: Pfizer; Financial Interests, Personal, Other, IDMC DESTINY 05: Daiichi Sankyo; Financial Interests, Personal, Advisory Board, GCSF and FN in older patients: Sandoz; Financial Interests, Personal, Advisory Board, Underserved Patients Populations with breast cancer, advisory board: Pfizer; Financial Interests, Personal, Invited Speaker, Management of older patients with cancer, series of seminars in Canada for HCP: Pfizer; Financial Interests, Personal, Invited Speaker, Symposium during SIOG annual meeting 1/11/2023: Daiichi; Financial Interests, Personal, Invited Speaker, RWD in myeloma and older patients, Prohgress, 17/11/2023: Takeda; Financial Interests, Personal, Invited Speaker, TIBCS, taipei, older patienst with breast cancer, 21/09/2023: Pfizer; Financial Interests, Personal, Invited Speaker, Series of lectures in Montreal/Quebec on breast cancer management in older ones, 09-13/10/2023: Pfizer; Financial Interests, Personal, Advisory Board, Elacestrant and BC, 13/03/2023: Menarini; Financial Interests, Personal, Invited Speaker, 29/03/2023 symposium during SFH annual meeting, RWD and older patients: Incyte; Financial Interests, Personal, Invited Speaker, Patients pathways for nurse practioners: AstraZeneca; Financial Interests, Institutional, Coordinating PI, APPALACHES study EORTC 1745: Pfizer; Financial Interests, Institutional, Coordinating PI, TOUCH study (IBCSG 55/GERICO study): Pfizer; Financial Interests, Institutional, Local PI, DEESTINY 09: DAIICHI; Financial Interests, Institutional, Local PI, DESTINY 06: DAIICHI; Financial Interests, Institutional, Local PI, SERENA 06: AstraZeneca; Non-Financial Interests, Member of Board of Directors, General secretary: EORTC; Non-Financial Interests, Member of Board of Directors: SIOG, BIG; Non-Financial Interests, Member of Board of Directors, treasurer: EBCC. L. Mourey: Financial Interests, Personal, Advisory Board: Astellas, Janssen, MSD, BMS, Ipsen, AstraZeneca, Pfizer, AAA. F. Canouï-Poitrine: Financial Interests, Personal, Invited Speaker, Invited Speaker : the advanced Practice Nurses: Viatris. A. Diab, E. Nouhaud, M. Autheman, J.G. Fanton d'Andon, J. Ancillon, C. Ferté: Financial Interests, Personal, Other: Resilience Care. C.P. Massard: Other, Other, Christophe Massard: Consultant/Advisory fees from Amgen, Astellas, AstraZeneca, Bayer Ipsen, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, Netcancer, PegascyPrincipal/sub-Investigator of Clinical Trials for Abbvie, Aduro, Agios, Amgen, Argen-x, Astex, AstraZeneca, Aveo pharmaceuticals, Bayer, Beigene, Blueprint, BMS, Boeringer Ingelheim, Celgene, Chugai, Clovis, Daiichi Sankyo, Debiopharm, Eisai, Eos, Exelixis, Forma, Gamamabs, Genentech, Gortec, GSK, H3 biomedecine, Incyte, Innate Pharma, Janssen, Kura Oncology, Kyowa, Lilly, Loxo, Lysarc, Lytix Biopharma, Medimmune, Menarini, Merus, MSD, Nanobiotix, Nektar Therapeutics, Novartis, Octimet, Oncoethix, Oncopeptides AB, Orion, Pfizer, Pharmamar, Pierre Fabre, Roche, Sanofi, Servier, Sierra Oncology, Taiho, Takeda, Tesaro, Xencor: Company. F. Scotté: Financial Interests, Personal, Advisory Board, Meetings: Leo Pharma; Financial Interests, Personal, Invited Speaker, symposia: Amgen, MSD, Thermofisher, BMS, Pfizer, MundiPharma, Tilray; Financial Interests, Personal, Invited Speaker: Pierre Fabre Oncology, Clovis Oncology, Gilead, Grünenthal, Pharmanovia; Financial Interests, Personal, Advisory Board: Viatris-Mylan, Viforpharma, Helsinn, Chugai, Sanofi, Sandoz, GSK; Non-Financial Interests, Other, member of faculty for supportive and palliative care: ESMO; Non-Financial Interests, Member of Board of Directors: MASCC, AFSOS. All other authors have declared no conflicts of interest.