Feasibility and Utility of Incorporating Patient-Reported Outcomes into Surveillance Strategies for Advanced Lung Cancer

Abstract

Purpose

To identify and to describe patient-reported outcomes (PROs) in lung cancer patients and to evaluate the feasibility and utility of PROs into surveillance strategies, a review was carried out.

Patients and Methods

A systematic search in bibliographic databases evaluating the instruments used in PROs of non-small-Cell lung cancer (NSCLC) patients was done.

Results

From August 2014 to August 2019, 33 studies were included in this review and 16,491 patients were evaluated. PROs were divided into 6 different categories: 1) PROs as a guide in therapeutic choice, 2) PROs as indicator of disease progression, 3) agreement between PROs and the evaluated parameters, 4) PROs to evaluate the effects of immunotherapy, 5) need to deepen the knowledge of PROs, and 6) use of new electronic PROs.

Conclusion

The most frequently used instruments are EORTC QLQ-30 (16, 50%) and EORTC LC-13 (14, 43.75%) and in some studies (37.5%) they are used together. For different reasons (disease progression, adverse event, death, incomplete participation, etc.), the completion of these instruments decreased over time from baseline to subsequent measurements. This review demonstrates that PROs can play an important role as part of health care, and that routine use implementation could improve patient management in addition to the traditionally collected outcome.

Keywords:

• quality of life
• lung cancer
• patient-reported outcomes
• PROs

Abbreviations

SF-36, 36-item Short-Form Health Survey; MDASI, MD Anderson Symptom Inventory; DFS, disease-free survival; EAT-10, Eating Assessment Tool; ESAS, Edmonton Symptom Assessment Scale; EMA, European Medicines Agency; EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; FDA, Food and Drug Administration; FAACT, Functional Assessment of Anorexia/Cachexia Treatment; FACT - F, Functional Assessment of Cancer Therapy - Fatigue; FACT - G, Functional Assessment of Cancer Therapy - General; FACT - L, Functional Assessment of Cancer Therapy - Lung Cancer; HR QoL, health-related quality of life; LCSS, Lung Cancer Symptom Scale; NSCLC-SAQ, Non-Small Cell Lung Cancer Symptom Assessment Questionnaire; OS, overall survival; PROs, Patient Reported Outcomes; PG-SGA, Patient-Generated Subjective Global Assessment; PRO-CTCAE, Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events; PCM, Patients’ symptoms via the Patient Care Monitor; RALS, Rotterdam Activity Level Scale; SWAL-QoL, Swallowing Quality of Life instrument; LCS, The Lung Cancer Subscale; SCFS, The Schwartz Cancer Fatigue Scale; TKIs, tyrosine kinase inhibitors; WPAIGH, Work Productivity and Activity Impairment: General Health; ZBI, Zarit Burden Interview.

Author Contributions

All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

Luigi Cavanna reports consulting and advisory roles for AstraZeneca and Merck; travel and accommodation expenses from Celgene, Pfizer, and Ipsen. The other authors have no financial support or relationships that may pose a conflict of interest with this work.