Feasibility of mobile device-based patient-reported outcomes in real-world clinical settings for non-small cell lung cancer

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Purpose: This study evaluated the feasibility and clinical utility of a mobile application-based electronic patient-reported outcome (ePRO) system for longitudinal symptom monitoring in patients with lung cancer receiving systemic therapy.Methods: We developed a mobile application-based ePRO platform for patients with lung cancer receiving chemotherapy and/or immunotherapy in South Korea. Twenty-one treatment- related symptoms were selected from regulatory drug labeling and mapped to Patient- Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) items. Patients reported symptoms every 3 days or as needed, while clinicians reviewed the summarized data via a web-based interface. The adherence, usability, and concordance between patient- and clinician-reported adverse events (AEs) were assessed.Results: A total of 26 patients used the application, generating 570 symptom reports over a mean follow-up duration of 70.3±64.5 days. The mean adherence rate was 81.9%±21.5%. The most frequently reported symptoms were fatigue (67.7%), shortness of breath (60.1%), decreased appetite (59.9%), insomnia (57.6%), and pain (53.8%), with decreased appetite, fatigue, and shortness of breath being the most common grade ≥2 symptoms. Symptom patterns varied according to the treatment regimen and were consistent with known toxicity profiles. Clinician-documented AEs were primarily limited to laboratory abnormalities, whereas ePRO captured a broader range of subjective symptoms. Longitudinal analysis revealed sustained weekly reporting, regimen-specific temporal symptom trajectories, and higher symptom severity in unscheduled reports than in scheduled reports.Conclusion: Mobile application-based longitudinal ePRO monitoring was feasible, well accepted, and clinically informative for lung cancer care. These findings support further evaluation of mobile ePRO systems in routine practice.

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