Eric Topol published a Commentary on Medscape describing a study published in JAMA in which cancer patients that tracked 12 symptoms and shared the tracking results with their health teams had a five months increase in survival equivalent with some of the most promising drugs.
The conclusion of the commentary:
Why is this trial so important? First, it is not a stand-alone result but the replication of one with concordant results, now with a fivefold increase in sample size and long-term follow-up (instead of premature discontinuation).
Second, the improvement in survival of > 5 months compares quite favorably with the median survival improvement in major oncology drug trials, such as those seen with the exciting results of immunotherapy. Many of these trials have shown a 3-month median survival improvement for new drugs, leading to commercial approval and costing at least $100,000 per treatment.
But unlike the drug trials, there was little promotion or coverage. The only major newspaper that reported on the trial was the Washington Post. This might have been anticipated; there is no sponsor. The ASCO meeting is characterized by the reporting of hundreds of drug trials, but it turned out that a digital medicine trial had striking results that largely outperformed most of the expensive and heavily promoted biopharma interventions. The digital tracking strategy costs very little: an app, an algorithm, and a strategy for clinician response. But that represents a de minimis amount considering the outcome of improved survival—or the new drug cost of $100,000 per patient.
Most important, this trial emphasizes the role of engaging patients in tracking their symptoms and of generating their own data. Patients have long been neglected for having a more active role in their care, when in fact, given the appropriate tools, they represent true “blockbuster” potential for improving their outcomes.