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Abstract Introduction: Remote symptom monitoring is becoming more common in the management of patients on active cancer treatments. The patterns of symptoms and subsequent alerts for specific types of treatment administered as part of standard of care remains unknown. This study aims to characterize the frequencies and types of symptom alerts among breast cancer patients receiving neoadjuvant and adjuvant therapy. Methods: This secondary analysis used data from a hybrid type 2 randomized controlled trial testing the implementation of remote symptom monitoring. For our analysis, we included women with breast cancer receiving (neo)adjuvant therapy. Enrolled patients received remote symptom monitoring surveys within 30 days of treatment initiation at the University of Alabama at Birmingham from 06/2021 to 05/2023. Self-reported symptoms were recorded via weekly electronic surveys for six months. The weekly survey used the PRO-CTCAE measurement tool and patients report frequency, intensity, and interference of the following symptoms: constipation, decreased appetite, diarrhea, cough, insomnia, nausea/vomiting, neuropathy, pain, urinary problems. Symptom alert severity is categorized as either moderate or severe. Self-reported race and treatment regimen (within the first 60 days) were abstracted from the electronic medical record. Regimens were grouped into three categories 1) trastuzumab-containing, 2) any regimen with pembrolizumab, 3) chemotherapy without trastuzumab or pembrolizumab. Descriptive statistics were calculated using frequencies and percentages for categorical variables and medians and interquartile ranges (IQR) for categorical variables. Results: A total of 108 women with breast cancer were included in our analysis. Overall, 54% were of White race, 36.1% were of Black or African American race, and 1.85% were of Asian race. The median age was 54 years (IQR 41-65). Fifty-one percent were prescribed a chemotherapy regimen, 33% trastuzumab-based regimen, and 15% pembrolizumab-based regimen. Symptom alerts were addressed supportively or escalated with nursing and treating oncologist via direct communication with patients. A total of 1438 symptom alerts were triggered with 55% of surveys generating an alert. The most reported symptom alert was pain, accounting for 30% of all alerts. Additionally, of all symptom alerts, 70% were moderate and 30% severe, with similar distributions across regimens. Patients receiving pembrolizumab regimen most often reported moderate pain compared to the other two regimens (35% vs 22% vs 23%). However, severe pain was most often reported by those receiving chemotherapy at 46%, trastuzumab-based regimen at 40%, and pembrolizumab-based regimen at 31%. Furthermore, patients on trastuzumab-based regimens reported severe diarrhea most frequently (11%) compared to 3% 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-12-11.
Khoury et al. (Thu,) studied this question.