Enhancing Oncology Care: The Role of Patient-Reported Outcomes

In a significant advancement for oncology, a recent study published in *Nature Medicine* highlights the impact of patient-reported outcomes (PROs) on cancer care, despite not achieving an increase in overall survival (OS). The PRO-TECT trial, led by Dr. Maurie Markman from City of Hope, evaluated the efficacy of symptom monitoring through electronic surveys in a large cohort of oncology practices. Conducted with 1,191 patients across 52 sites, the trial aimed to assess whether implementing PRO surveys could enhance patient care and treatment outcomes.

The PRO-TECT study's findings indicate that while there was no statistical improvement in OS among participants, significant benefits were noted in symptom management and quality of life. Specifically, patients who engaged with PRO surveys experienced a 6% reduction in emergency room visits, a delay in the deterioration of physical function, and enhanced health-related quality of life metrics. Dr. Markman noted, "These results are critically important for the practice of oncology, as they provide insight into how we can better manage symptoms and improve patient satisfaction."

Dr. Markman emphasized that the study represents a shift towards integrating PROs as a standard of care in oncology practices. Historically, research in this area has primarily focused on academic medical centers. This trial, however, broadened its scope to include diverse patient populations, reinforcing the notion that symptom monitoring is beneficial across various settings.

The study's design involved randomizing practices into two groups: one that utilized the PRO surveys and another that continued with usual care. Patients in the PRO group completed weekly symptom surveys, which triggered alerts for their care teams in cases of severe or worsening symptoms. This proactive approach not only empowered patients but also facilitated timely interventions by healthcare providers.

Despite the lack of a survival benefit, the data suggest that 77% of patients felt that the PRO tool improved their interactions with healthcare providers, fostering a sense of control over their treatment. Moreover, the high compliance rate of 91.5% in completing the weekly surveys indicates strong patient engagement.

Experts in the field are cautiously optimistic about the implications of these findings. Dr. Ellen T. Harten, an oncologist at the University of California, Los Angeles, remarked, "This study underscores the importance of patient voice in oncology care. While survival is a critical endpoint, enhancing quality of life must also be prioritized."

On the international front, the World Health Organization (WHO) has endorsed the integration of PROs in cancer care, citing their potential to improve patient outcomes and satisfaction globally. According to a 2022 WHO report, cancer care strategies that incorporate patient feedback lead to better therapeutic adherence and overall patient well-being.

Looking ahead, Dr. Markman and his team plan to conduct further research that shifts the focus from survival metrics to other meaningful endpoints that reflect patient experiences. This aligns with a growing recognition in the medical community that patient-centered care is essential, particularly in oncology, where treatment can be complex and burdensome.

In conclusion, while the PRO-TECT study did not demonstrate an increase in overall survival, its findings underscore the value of patient-reported outcomes in enhancing the quality of cancer care. As the oncology field continues to evolve, integrating patient feedback will likely play a pivotal role in shaping future treatment paradigms, ensuring that the patient experience remains at the forefront of cancer management strategies.