Real-world ePRO use and clinical outcomes using electronic patient-reported symptom monitoring for patients with advanced non-small-cell lung cancer receiving first-line pembrolizumab
Aim: This ambispective observational study assessed the impact of Noona, an electronic patient-reported outcomes (ePRO) platform, for patients with non-small cell lung cancer (NSCLC) treated in a community oncology setting. Methods: Adults with advanced NSCLC, ECOG performance status of 0–2, who r...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Becaris Publishing Limited
2025-01-01
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| Series: | Journal of Comparative Effectiveness Research |
| Subjects: | |
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| Summary: | Aim: This ambispective observational study assessed the impact of Noona, an electronic patient-reported
outcomes (ePRO) platform, for patients with non-small cell lung cancer (NSCLC) treated in a community
oncology setting. Methods: Adults with advanced NSCLC, ECOG performance status of 0–2, who received
first-line (1L) pembrolizumab (monotherapy or with chemotherapy) were eligible. Those initiating
pembrolizumab from 1 July 2017 to 30 June 2019, identified retrospectively (historical cohort), were
compared with those initiating pembrolizumab from 1 October 2019 to 30 September 2021 who
were prospectively offered Noona (standard of care [SoC] cohort). The Kaplan–Meier method and Cox
proportional hazards models were used to compare pembrolizumab real-world time on treatment (rwToT;
primary outcome measure) and rw time to next treatment or death (rwTTNTD) between historical and
SoC cohorts. Healthcare resource use (HCRU) was compared using generalized linear models with Poisson
distribution. Analyses were repeated to compare outcomes in the SoC cohort between Noona users
(created a profile and used any function ≥one-time during 1L therapy) and nonusers with >42 days on
1L pembrolizumab. Data cutoff was 30 June 2020 and 30 September 2022 for historical and SoC cohorts,
respectively. Results: Median pembrolizumab rwToT was 4.4 months (95% CI: 3.9–5.1) in the historical
cohort (n = 448) versus 4.1 months (95% CI: 3.3–4.8) in the SoC cohort (n = 462; adjusted hazard ratio [aHR],
0.9; 95% CI: 0.8–1.0; p = 0.14 vs historical cohort). In the SoC cohort, 147 of 341 eligible patients (43%)
established a Noona profile; 122/341 (36%) were Noona users. Median rwToT was 6.4 months (95% CI:
5.1–7.4) and 6.9 months (95% CI: 5.6–7.6) among Noona users and Noona nonusers (n = 219), respectively
(aHR, 1.1; 95% CI: 0.8–1.4; p = 0.95 vs Noona users). The rwTTNTD and HCRU were comparable in historical
versus SoC cohorts and for Noona users versus nonusers. During the first year after establishing a Noona
profile, 92 of 147 patients (63%) used the platform; monthly use was 32–42%, and checking laboratory
results was the most used function overall (by 52% of the 147). Conclusion: Notwithstanding the null
findings of this study, positive results of ePRO use in clinical trials and observational studies support the
treatment-related symptom monitoring and survival benefits of ePRO utilization. |
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| ISSN: | 2042-6313 |