Exploring Symptom Burden, Treatment Bother, Physical Function, and Quality of Life By Frailty Status in Patients with Colorectal Cancer (CRC)

Speaker(s)

Galaznik A1, Coombs N2, Beamon E3, Rusli E4, Wujcik D1, Saltzman JN5
1Carevive Systems, Inc, Boston, MA, USA, 2Piedmont Research Strategies, Billings, MT, USA, 3Piedmont Research Strategies, Greenville, NC, USA, 4Carevive Systems, Inc, Newton, MA, USA, 5Cleveland Clinic, Cleveland, OH, USA

Presentation Documents

OBJECTIVES: Research indicates prognostic value of frailty status (FS) in resectable CRC and in treatment selection for older, frailer patients with metastastic CRC. Electronic Patient Reported Outcomes (ePROs) enable capture of real-world patient experiences and associated health outcomes. Using ePROs, this study explores symptom burden, symptom bother, physical function, and quality of life (QoL) across fit, intermediate, and frail CRC patients.

METHODS: All adult patients with CRC and evidence of active treatment were enrolled in the Carevive PROmPT® remote symptom monitoring (RSM) platform between September 2020 and March 2023. Baseline data included age, sex, race and FS. Classification of FS (fit, intermediate, frail) were triangulated from three separate sources: modified Geriatric Assessment (mGA), CARE GA survey, and self-reported activity. Validated psychometric tools captured symptoms (PRO-CTCAE), treatment bother (FACT-GP5), physical function (PROMIS-4a) and QOL (EORTC QLQ #29-30). All results were stratified by FS.

RESULTS: Of 128 patients, 39% were >60 years and 73% were white. Median follow time was 12 weeks. FS was successfully classified for 119 (93%) patients with 81 (68%) fit, 19 (16%) intermediate, and 19 (16%) frail. The most frequently reported symptoms were nausea, numbness/tingling, and pain. Symptom burden was directionally lower for fit compared to intermediate and frail patients. Physical function exhibited no change across 12 weeks; non-static levels were consistently highest, and comparable for fit and intermediate patients. Physical function was 30% higher for fit and intermediate compared to frail patients. QoL results were directionally comparable.

CONCLUSIONS: We demonstrated feasibility of using RSM for gathering data on frailty status, symptom burden, treatment bother, physical function, and QoL. Findings suggest there may be functional differences in patient experience at different levels of frailty, supporting the importance of using FS to identify actionable risk factors for poor health outcomes and better align goals of care for CRC patients.

Code

PCR164

Topic

Clinical Outcomes, Patient-Centered Research

Topic Subcategory

Clinical Outcomes Assessment, Patient Engagement, Patient-reported Outcomes & Quality of Life Outcomes

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Oncology