Patient-Reported Outcome Measures Used in Routine Care Predict for Survival at Disease Progression in Patients With Advanced Lung Cancer

The patient-reported outcomes (PROs) used in routine care are not easily interpreted. We evaluated symptom development during first-line palliative treatment using electronic PROs from 94 patients with advanced lung cancer. We identified specific symptom scales that predict for survival at disease progression. These results can aid in the clinical interpretation of PROs used for decision-making. Background: Patient-reported outcome (PRO) measures have been increasingly implemented in routine care to aid in clinical decision-making. However, the prognostic value of PRO measures as a tool for decision making is not easily interpreted by clinicians. Our aims were to explore the prognostic value of PRO measures at disease progression and the changes in PRO measures between treatment start (baseline) and disease progression. Patients and Methods: Since 2014, patients with lung cancer have completed an electronic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires C30 and LC-13 before every outpatient visit at the Department of Oncology, Hospital Unit West, Jutland, Denmark. The patients' responses were used in routine care. Patients receiving palliative antineoplastic treatment were eligible for analysis if the questionnaire had been completed at the initiation of first-line treatment and at disease progression. The prognostic value of the scores was evaluated using a Cox proportional hazard model. A P value < .01 was considered statistically significant. Results: A total of 94 screened patients were included. At disease progression, survival could be predicted from the absolute score of the global health scale, 3 functional scales (physical, role, emotional), and 7 symptom scales (fatigue, pain, dyspnea, hemoptysis, lung cancer dyspnea, chest pain). In addition, changes in hemoptysis, dysphagia, dyspnea, and chest pain predicted for survival at progression. Conclusion: PRO measures used in routine care can provide clinicians with relevant prognostic information about patients with lung cancer at disease progression. These results show the potential value of PRO measures when used in clinical decision-making. (C) 2020 The Author(s). Published by Elsevier Inc.

Automated summary

This study evaluated symptom development in patients with advanced lung cancer during palliative treatment using electronic PROs. Specific symptom scales were identified to predict survival at disease progression. The results show the potential value of using PRO measures in clinical decision-making for patients with lung cancer.