European journal of cancer (Oxford, England : 1990) · 2025
A randomized trial of patient navigation with symptom-monitoring in advanced lung cancer.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Prabhash Kumar, Noronha Vanita, Patil Vijay, Menon Nandini, Shah Minit, Singh Ajay, Pande Nikhil, Goud Supriya, More Sucheta, Sharma Rangita, Yadav Akanksha, Nakti Dipti, Panda Goutam, Saha Saswata, Pawar Akash, Shetake Ankush, Shah Srushti, Nawale Kavita, Sharma Sanjeev, Banavali Shripad, Goel Nishu, Badwe Rajendra
Аннотация
AIM: Patient navigators can help overcome barriers to cancer care. We evaluated the impact of patient navigation with symptom-monitoring in patients with advanced lung cancer.
METHODS: In this randomized study, adult patients (>18 years) with advanced lung cancer planned for palliative systemic therapy were assigned 1:1 to an intervention or standard care arm. Patients in the intervention arm were paired with a navigator who coordinated investigations, scheduled appointments, facilitated access to services, and conducted regular telephone-based or in-person symptom monitoring. The primary endpoint was change in quality-of-life (QoL) from baseline to 12 weeks. Secondary endpoints included time-to-treatment initiation, performance status deterioration, unplanned/emergency visits, treatment compliance, symptom documentation, progression-free (PFS), and overall survival (OS).
RESULTS: Between February and November 2022, we enrolled 150 patients: 75 per arm. Broad-panel molecular testing was performed more often in the intervention arm (44 % vs. 10 %; P < 0.001); overall molecular testing (any biomarker) in 86 % vs. 77 %. The mean time-to-treatment initiation was significantly shorter in the intervention group (19 vs. 28 days; P < 0.001). Emergency/unplanned visits were less frequent (67 % vs. 88 %; P = 0.002), and compliance was higher (85 % vs. 68 %; P = 0.012) in the intervention arm. Symptoms were documented in 93.2 % vs. 8.1 % (intervention vs. control). There were no significant differences in QoL change (mean 40.50 vs. 40.78; P = 0.906), performance status deterioration (2.79 vs. 2.27 months; P = 0.650), median PFS (6.47 vs. 7.49 months; P = 0.79) or median OS (11.93 vs. 13.86 months; P = 0.69).
CONCLUSION: Patient navigation with symptom monitoring improves care delivery by expediting treatment initiation, improving compliance, and reducing unplanned visits, without impacting QoL or survival.
METHODS: In this randomized study, adult patients (>18 years) with advanced lung cancer planned for palliative systemic therapy were assigned 1:1 to an intervention or standard care arm. Patients in the intervention arm were paired with a navigator who coordinated investigations, scheduled appointments, facilitated access to services, and conducted regular telephone-based or in-person symptom monitoring. The primary endpoint was change in quality-of-life (QoL) from baseline to 12 weeks. Secondary endpoints included time-to-treatment initiation, performance status deterioration, unplanned/emergency visits, treatment compliance, symptom documentation, progression-free (PFS), and overall survival (OS).
RESULTS: Between February and November 2022, we enrolled 150 patients: 75 per arm. Broad-panel molecular testing was performed more often in the intervention arm (44 % vs. 10 %; P < 0.001); overall molecular testing (any biomarker) in 86 % vs. 77 %. The mean time-to-treatment initiation was significantly shorter in the intervention group (19 vs. 28 days; P < 0.001). Emergency/unplanned visits were less frequent (67 % vs. 88 %; P = 0.002), and compliance was higher (85 % vs. 68 %; P = 0.012) in the intervention arm. Symptoms were documented in 93.2 % vs. 8.1 % (intervention vs. control). There were no significant differences in QoL change (mean 40.50 vs. 40.78; P = 0.906), performance status deterioration (2.79 vs. 2.27 months; P = 0.650), median PFS (6.47 vs. 7.49 months; P = 0.79) or median OS (11.93 vs. 13.86 months; P = 0.69).
CONCLUSION: Patient navigation with symptom monitoring improves care delivery by expediting treatment initiation, improving compliance, and reducing unplanned visits, without impacting QoL or survival.