Remote Symptom Alerts and Patient-Reported Outcomes (PROs) in Real-World Breast Cancer Practice: Innovative Data to Derive Symptom Burden and Quality of Life

Authors:Emelly Rusli MPH¹, Debra Wujcik PhD RN¹, Aaron Galaznik MD MBA¹

¹ Carevive Systems, Inc., Boston, MA

Prior studies have shown the value of routine symptom monitoring and patientreported outcomes (PROs) assessments on oncology patient outcomes.^1,2,4
Women undergoing breast cancer treatment may experience debilitating symptoms that can significantly reduce quality-of-life (QoL).⁴
Continued monitoring using remote symptom monitoring platform (RSM) with an alert system allows patients to report symptoms and inform the healthcare team in real time.
Insights on patient experiences with symptom prevalence and their impact to daily function and QoL, particularly in patients with poor functional status5, is essential for treatment decision making.
This research aims to highlight the use of data collected via PRO-generated alerts system to characterize symptom burden and QoL in real-world breast cancer population.

Breast cancer patients enrolled in Carevive PROmpt®, an RSM platform, between September 2020 and November 2023 with evidence of therapy were included.
Patients received weekly surveys to report any symptoms (derived from PROCTCAE^®) experienced during treatment. When a patient reported a moderate or severe symptom, an algorithm-based system would generate an “alert” notification to the healthcare team.
The healthcare team was notified and documented the clinical action(s) taken to address the symptoms. Patient-reported quality of life and physical function data were visible to the care team upon alert generation.
Patients were followed from the baseline survey completion to the last completed survey or end of study period (whichever is earliest).
Symptom burden, measured by the number of alerts/week and symptom prevalence, as well as QoL (measured by the Global health/QOL items of EORTC QLQ-C30) at alerts were characterized.
Results were explored by stage (early or late), biomarker (Her2+/HR+, Her2-/HR+ or TNBC), age, frailty (Frail, Intermediate, or Fit) and ECOG status (0, 1, or 2+).

Data collected from PRO-generated alerts system can be used to characterize symptom burden and quality of life in breast cancer.
Frail and ECOG 2+ patients generated more alerts per patient per week, indicative of higher symptom burden.
Patients with poor functional status may greatly benefit from continuous monitoring of symptoms, function, and quality-of-life over time.
Early identification of patients with poor functional status allows clinicians to tailor monitoring frequency.
Results can inform future studies on interventions to mitigate symptoms in high-risk breast cancer patients with poor functional status.

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