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Groundbreaking Study Reveals Patient-Reported Outcomes as Key Predictors of Treatment Response and Survival in Advanced Gastrointestinal Cancer

Early changes in patient-reported outcomes (PROs) prove more reliable than tumor markers, indicating potential paradigm shift in cancer monitoring.

In a groundbreaking prospective cohort study involving 159 patients with advanced gastrointestinal cancer, researchers at Massachusetts General Hospital Cancer Center discovered that early changes in PROs, specifically quality of life and symptom assessments, are closely associated with treatment response, progression-free survival, and overall survival. These findings challenge the conventional reliance on serum tumor markers (TMs) and imaging for monitoring clinical outcomes in cancer patients.

The study, conducted from May 2019 to December 2020, enrolled patients initiating first-line systemic therapy for metastatic pancreaticobiliary, colorectal, or gastroesophageal cancer. Notably, the research revealed that changes in PROs after just one month were indicative of treatment response, highlighting the potential for PROs to serve as valuable biomarkers in clinical decision-making.

Unlike tumor markers, which did not consistently correlate with outcomes, changes in PROs were significantly associated with clinical benefit, progression-free survival, and overall survival. The researchers used measures such as the Functional Assessment of Cancer Therapy-General (FACT-G), Edmonton Symptom Assessment System (ESAS), and Patient Health Questionnaire-4 (PHQ4) to assess various aspects of patients’ quality of life, physical symptoms, and psychological well-being.

The study’s lead investigator emphasized that these findings underscore the need for a shift in clinical practice, emphasizing routine monitoring and addressing changes in patients’ quality of life and symptoms.

This groundbreaking study opens new avenues for personalized cancer care, offering a more patient-centric approach to treatment monitoring and decision-making. The integration of PROs into routine clinical practice could provide a more comprehensive understanding of a patient’s response to treatment and potentially lead to improved outcomes in advanced gastrointestinal cancer.

Credit: JAMA Network Open