The edition · Oncology
Weekly online symptom reporting was linked to five months' longer survival in lung cancer
Long-term follow-up of SYMPRO-Lung extends patient-reported symptom monitoring beyond advanced disease and research-grade programmes. Also: induction and consolidation camrelizumab in limited-stage small cell lung cancer, and wildfire smoke and survival after a lung cancer diagnosis.
The edition in brief
In a post hoc survival analysis of SYMPRO-Lung, a stepped-wedge cluster-randomised trial at 14 Dutch centres, 446 patients with stage I–IV lung cancer starting new treatment either completed weekly online symptom reports for a year or received usual care. At a median 50 months, median overall survival was 26 versus 21 months (adjusted HR 0.80, 95% CI 0.63–1.00, p = 0.049); progression-free survival did not differ. A randomised phase II trial of 41 patients with limited-stage small cell lung cancer found that adding camrelizumab to induction chemotherapy and as consolidation after chemoradiotherapy raised one-year progression-free survival from 47.4% to 65.5%, with median PFS 24.0 versus 11.8 months. Among 414,016 older US patients with lung cancer, each 1 µg/m³ of wildfire-related PM2.5 was associated with about 8% higher mortality, against about 2% for other PM2.5.
Adding camrelizumab before and after chemoradiotherapy doubled median PFS in a small limited-stage SCLC trial
Treat this as phase II evidence supporting larger trials of induction immunotherapy, not a reason to change current limited-stage SCLC practice.
Wildfire smoke particulates were linked to higher mortality after a lung cancer diagnosis, unit for unit more than other PM2.5
Include practical air-quality advice, such as limiting exposure on high-pollution days, in care for patients with lung cancer.
New breathlessness or diarrhoea on a checkpoint inhibitor is immune-related until shown otherwise
Treat new respiratory or bowel symptoms in a patient on a checkpoint inhibitor as possible immune toxicity and involve oncology early.
Weekly patient-reported symptom monitoring was associated with longer survival across all stages of lung cancer
Consider building weekly patient-reported symptom monitoring with clinician alerts into routine care for patients treated for lung cancer.
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