A Smartphone App Can Improve Survival in Patients with Lung Cancer

By John Henry Dreyfuss, MDalert.com staff.

Save to PDF OncologyTechnologyEvidence-Based Medicine By
  • Patients who used the app survived 7 months longer, on average, than those who did not use it.
  • Approximately 75% of high-risk lung cancer patients were alive 1 year after they started using the app, compared with 49% of patients who received typical cancer care.
  • Prospective, randomized trail included 121 patients.
  • Smartphone application may enable patients to earlier alerts to caregivers.

A prospective, randomized trial suggests a significant survival improvement after lung cancer (Figure 1) diagnosis using a smartphone and web-application. Applications-guided follow-up enabled better performance status (PS) at relapse, earlier supportive care and reduction of routine imaging. The results were presented at the 2016 annual meeting of the American Society of Clinical Oncology (ACSC).

 

Figure 2. Lung cancer causes by source and year.
(Sources: By C0NPAQ/Wikipedia.)

 

Patients who used the app survived 7 months longer, on average, when using the Moovcare app—about 19 months compared to an average of 12 months for nonusers.

The Moovcare smartphone and web application proved so effective that researchers ended the clinical trial early, said study author Dr. Fabrice Denis, a researcher at the Institut Inter-regional de Cancerologie Jean Bernard in Le Mans, France, according to a report from HealthDay published on MedlinePlus.com.

Approximately 75% of high-risk lung cancer patients were alive 1 year after they began using the app, compared with 49% of patients who received typical cancer care, explained Dr. Denis.

The app developers intended it to provide early detection of symptomatic relapse, complications, and need for supportive care between patient visits. An analysis of the weekly self-reported symptoms automatically triggered a request for a physician visit.

The Phase 3 trial was performed at multiple institutions and was designed to compare web-application follow-up (experimental arm) a clinical routine assessment with a CT-scan (every 3-6 months or at investigator’s discretion; standard arm). The app enabled patients to report self-scored symptoms that were sent weekly sent (between planned visits) to the oncologist. Patients in the standard arm received scheduled clinical assessment and CT scan at 3 or 6 months.

 

Figure 2. A chest X-ray showing a tumor in the lung.
(Sources: By James Heilman, MD [Own work]/Wikimedia Commons..)


The number of imaging scans was reduced by 50% per patient per year among those who used the app. Among patients who had relapsing disease, about 74% of those who used the Moovcare app were healthy enough to endure optimal cancer care. Only 33% of patients with relapsing disease who did not use the app were healthy enough for such care. Use of the Moovecare app also resulted in decreased cost of care through lower consumption of healthcare resources among app users.

The Analysis

The primary endpoint in this trial was detection of an improvement of 12% in 9 months’ survival in favor of the experimental arm (α=5%, β=20%, unilateral test). The boundary for declaring superiority with respect to overall survival at the pre-planned interim analysis was a P<0.006. The PS at relapse, the quality of life (QOL) and cost-effectiveness were also investigated.

The study included 121 patients in an intent-to-test survival analysis; 90% patients had stage III/IV disease. The median age was 65 years. Median follow-up was 9 months. Median overall survival in months was 19 (11.8), P=0.0014 (n= 121; HR= 0.33; 95 % CI, 0.16-0.67) and the PS at the first relapse was 0-1 for 81.5% (35.3%) of the patients (P<0.001) in the experimental (standard) arm.

ASCO 2016 abstract number: LBA9006.

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