Abstract PS2-04-28: Symptom trajectories using remote symptom monitoring across treatment type and stage

Abstract Background: Remote symptom monitoring (RSM) using patient reported outcomes allow real-time reporting of symptoms from patients to their healthcare team. This provides a unique opportunity to understand symptom trajectories across stage and treatment. Methods: This retrospective cohort study is a secondary analysis of data from a hybrid, type 2 single-arm trial of a navigator-supported RSM program from May 2021-May 2024. Upon treatment initiation, patients self-reported pain, gastrointestinal, respiratory, and urinary symptoms via weekly surveys. Symptoms were categorized as moderate or severe using the PRO-CTACAE grading tool. Patients with at least one survey per month for three months were included. Generalized linear mixed-effect models estimated associations between 3-month symptom trajectories and stage (early EBC vs. metastatic MBC) or treatment (chemotherapy vs. targeted or immunotherapy) using odds ratios OR and 95% confidence intervals CI. Models were adjusted for age at treatment initiation, race, and comorbidity status, and included an interaction term for time and treatment or stage. Results: Of 292 patients, the median age was 55; most patients were white and had 2-3 comorbidities. A quarter of patients received targeted or immunotherapy and had MBC. Although results did not reach statistical significance, symptoms trajectories differed by treatment type and stage, as well as between specific symptoms (Table). Compared to those receiving chemotherapy, patients receiving targeted or immunotherapy had 36% higher odds of GI symptoms in month one (M1), with lower odds in M2, but higher odds in M3. The odds of respiratory symptoms were 54% lower for patients receiving targeted or immunotherapy initially (M1), and remained low in M2, but by M3 were similar to those receiving chemotherapy. The odds of urinary symptoms were 64% lower for patients receiving targeted or immunotherapy in M1 but became 83% higher in M2 and had two-fold higher odds in M3 compared to those receiving chemotherapy. The odds of pain for patients with targeted or immunotherapy vs. chemotherapy were only higher in M1. When comparing symptom trajectories by stage, patients with MBC had lower odds of GI symptoms in M1 and M2, but similar odds in M3 to those with EBC. The opposite trend was seen for respiratory disease where those with MBC saw higher odds in M1, M2, and M3 compared to EBC, though becoming more similar across time. The odds of urinary symptoms were similar across stage over time. Finally, the odds of pain were 51% higher in MBC vs. EBC patients in M1, 25% lower in M2, and similar in M3. Conclusion: Symptom trajectories in the first three months of treatment varied by treatment type and stage. Further evaluation is needed to understand how patterns may reflect initial acute vs. later cumulative toxicities occurring over time. Future studies utilizing a larger sample are needed to better generalize these findings. Citation Format: J. A. Franks, L. Deng, S. Olisakwe, C. Williams, A. Azuero, A. Falcao, E. Ortiz, I. Starks, C. Hogea, G. Rocque. Symptom trajectories using remote symptom monitoring across treatment type and stage abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-04-28.