Technology and its interventional value in patient-reported outcomes in cancer research, what is next?




Patient reported outcomes, Cancer research, Technology, Clinical trials


For cancer patients, health-related quality of life (QOL) is a critical aspect of care management decision-making. In some cases, clinicians have even prioritized QOL over survival in patients with advanced cancer. Over time, patient-reported outcomes (PRO) have gained prominence in cancer research to capture aspects of a patient's health condition, reported directly by the patient through a questionnaire through scales validated in different moments. PROs are currently used as a research tool in clinical trials for cancer drug development to monitor and assess the psychological and cognitive well-being of patients and detect significant symptoms. In addition to QOL, several studies have suggested that PROs also improve patient outcomes and satisfaction. Retrospective analyses have shown that QOL and its early palliative care are a prognostic factor for survival in cancer patients. Although, such results were not confirmed by others who have reported after a systematic review of 24 controlled trials a limited statistically significant impact of PRO, and that the effect sizes of interventional PROs were small to moderate.

Author Biography

Luis Mendoza, Medical Scientific and Sciences, Hematology and Oncology Unit, IQVIA, Czech Republic

Dr. Mendoza, as a Board Certified Medical Oncologist, has served as a medical and scientific consultant on many different Hematology and Oncology projects and clinical trials. He continued his doctoral studies in immunology-oncology at the Prague Academy of Sciences, where he worked on various types of cancer vaccines and became an expert in the field of dendritic cell vaccines. Dr. Mendoza has more than 28 years of experience in Hematology and Oncology and has extensive experience in the medical management of phase I-IV Hematology-Oncology studies testing various new anti-cancer compounds such as targeted therapies, immunotherapies, oncolytic viruses, antibody-drug conjugates. vaccines, chemotherapy, PARP and PI3K inhibitors, antiangiogenic drugs, among others. He has played a key role in the clinical development of many cancer drugs already on the market. He is the author and co-author of dozens medical and scientific publications in peer-reviewed journals.


Meropol NJ, Egleston BL, Buzaglo JS, Benson AB 3rd, Cegala DJ, Diefenbach MA et al. CONNECT Study Research Group. Cancer patient preferences for quality and length of life. Cancer. 2008;113(12):3459-66.

Fitzpatrick R, Davey C, Buxton MJ, Jones DR. Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess. 1998;2(14):1-74.

Chen J, Ou L, Hollis SJ. A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting. BMC Health Serv Res. 2013;13:211.

Quinten C, Coens C, Mauer M, Comte S, Sprangers MA, Cleeland C et al. EORTC Clinical Groups. Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncol. 2009;10(9):865-71.

Zimmermann C, Swami N, Krzyzanowska M, Hannon B, Leighl N, Oza A et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet. 2014;383(9930):1721-30.

Ambroggi M, Biasini C, Toscani I, Orlandi E, Berte R, Mazzari M et al. Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature. Support Care Cancer. 2018;26(9):2945-53.

Kotronoulas G, Kearney N, Maguire R. What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials. JCO. 2014;32(14):1480-501.

Howell D, Molloy S, Wilkinson K, Green E, Orchard K, Wang K et al. Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors. Ann Oncol. 2015;26(9):1846-58.

Reilly CM, Bruner DW, Mitchell SA, Minasian LM, Basch E, Dueck AC et al. A literature synthesis of symptom prevalence and severity in persons receiving active cancer treatment. Support Care Cancer. 2013;21(6):1525-50.

Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P et al. Symptom Monitoring with Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial. J Clin Oncol. 2016;34(6):557-65.

Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C et al. Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment. JAMA. 2017;318(2):197-8.

Denis F, Yossi S, Septans AL, Charron A, Voog E, Dupuis O et al. Improving Survival in Patients Treated for a Lung Cancer Using Self-Evaluated Symptoms Reported Through a Web Application. Am J Clin Oncol. 2017;40(5):464-9.

Ganser AL, Raymond SA, Pearson JD. Data quality and power in clinical trials: a comparison of ePRO and paper in a randomized trial. In: Byrom B, Tiplady B, editors. ePRO: electronic solutions for patient-reported data. Surray: Gower. 2010: 49-78.

Bottomley A, Reijneveld JC, Koller M, Flechtner H, Tomaszewski KA, Greimel E; 5th EORTC Quality of Life in Cancer Clinical Trials Conference Faculty. Current state of quality of life and patient-reported outcomes research. Eur J Cancer. 2019;121:55-63.






Letter to the Editor