Zosia Chustecka

June 06, 2016

CHICAGO — News released today at the annual meeting of the American Society of Clinical Oncology shows how lung cancer patients equipped with a smartphone helped themselves to live longer and better.

These were patients with high-risk lung cancer and good performance status who had already undergone first-line treatment. They were assigned either to standard care or to a web-based program in which patients reported their symptoms via a smartphone, and the program was configured to alert the oncologist whenever certain predefined clinical issues came up.

The study involved 121 patients and had a median follow-up of 9 months.

The results show that patients who were in the smartphone group lived for longer — median overall survival was 19.0 months vs 11.8 months in the standard-care group (P = .0014; hazard ratio, 0.33).

In addition, patients using smartphones had a better performance status when they relapsed, had earlier supportive care, and underwent less imaging than the patients who received standard care. Plus there were cost savings in the smartphone group.

The researchers, from the Institut de Cancérologie de l'Ouest, site René Gauducheau, Nantes, France, will present these findings (abstract LBA9006) on Monday, June 6.

No Reduction in Aggressive Care at End of Life

Other news released today at the meeting shows that there has been no reduction in aggressive care at the end of life in young cancer patients, despite recommendations against this practice.

The recommendation was made back in April 2012, in the first set of Choosing Wisely recommendations issued by ASCO. But it looks to have made little impact on clinical practice in the 2 years that followed.

Researchers found that aggressive chemotherapy was being used in about 70% of patients with different cancer types, and about 35% die in hospital, with only 14% to 18% enrolled in hospice care in the last days of life (abstract LBA10033; presented on Monday, June 6).

"Unfortunately, but perhaps not surprisingly, there was little impact of issuing that recommendation," commented Richard Schilsky, MD, ASCO chief medical officer and former chief of the section of hematology–oncology at the University of Chicago.

"The take-home message is that it is going to require a large cultural change among patients and doctors in order to move away from using aggressive cancer-directed treatment at the end of life, as has been widely recommended," he told Medscape Medical News. "We have to continue education on these issues," he added.

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