The medical and pharmaceutical communities have understandably been preoccupied with battling the COVID-19 pandemic over the last 18 months. But this massive reallocation of resources hasn’t come without a cost.
Pandemic-fuelled disruption to healthcare systems risks causing cancer death rates to rise for the first time in decades; while authorities have exacerbated the situation by urging patients to stay away from hospitals and emergency care, and delaying or cancelling scheduled surgeries.
Indeed, 24% of Americans with cancer delayed at least one in-person visit, while in the UK, an estimated 40,000 people are living with cancer without knowing it. Across both regions, delaying the first line of treatment risks leading to worse patient outcomes and a greater percentage of metastasis.
Fixing this imbalance will take a concerted effort from all parties. There’s an urgent need for the pharma and digital health industries to collaborate, improve patient monitoring and deliver more effective cancer treatments, now more than ever.
Put simply, they play a key role in remotely monitoring patients, most commonly by giving them prompts to report any symptoms they suffer. These may be associated with a relapse, when a patient whose cancer had originally been targeted with localized surgeries but reappears, or side effects of any drugs they may be taking.
This allows healthcare professionals to intervene and prescribe more serious treatments if required, such as immunotherapy, chemo, hormonal therapy, or a combination of these, as well as prescribing medications or altering the treatment to mitigate any side effects reported. Studies show health-related quality of life improves more significantly (34%) in patients whose treatments include digital solutions than in patients who receive the usual care (18%).
With the availability of healthcare professionals often stretched – and drug-based therapies becoming simpler and easier to self-administer at home – digital tools can effectively supplement the role of existing healthcare providers, ensuring patients are successfully onboarded to their treatment and can help ensure that their treatment is optimized.
The data these solutions provide can also guide decision-making around further treatment, pharmaceutical or otherwise, providing data that can assist patients and healthcare professionals in both short and long-term decision-making, helping set realistic patient expectations around treatment. FDA Oncology Drug approvals are rising exponentially, with guidance from digital tools increasing to support new options.
Finally, more broadly, digital health solutions can promote patient engagement and a clear understanding on how they can manage their condition. They can drive efficient and actionable communication with relevant healthcare professionals, while timely interventions based on patient-reported data can reduce hospitalization, keep patients on treatment longer and lead to progression-free survival.
Although the clinical benefits of remote patient monitoring have been demonstrated in clinical trials, achieving optimal supportive care in these trying times requires solutions that go further still.
Existing ‘generalist’ tools tend to have the goal of educating patients, or gathering data. While effective in enabling better care – and better continuity of care – more ambitious tools are now available that offer faster, more optimized, bespoke care to patients.
There’s scope to use these digital solutions to motivate and engage patients as well as target the specific unmet needs and side effects that can lead them to abandon treatment prematurely. This means turning to more complex tools to complement existing treatment, and gain a more detailed understanding of the patient journey in a medical world where interventions are growing exponentially due to combination therapy.
For pharma, innovation in oncology brings to mind drug-based treatments most often prescribed in the event of a relapse. While drug efficacy is vital, monitoring the patients’ symptoms and quality of life is equally important and is deeply entwined with prognosis and symptom alleviation.
Tracking patient-recorded outcomes (PROs) is one way digital health solutions can contribute to improving patient quality of life. Not only do these tools prompt patients to report symptoms associated with signs of relapse, identifying any need for drug treatments; they also empower patients to communicate and manage their existing treatment’s side effects to ensure they stay on medication, subsequently improving outcomes.
Research confirms this type of monitoring and reporting has a demonstrable impact on patient quality of life: a study by Basch et al (J Clin Oncol 34:557-565) shows health-related quality of life increased by 34% among those patients who reported common symptoms via tablet computers, compared with an 18% increase among control patients. The study also saw reduced emergency room visits and hospitalizations, and improved survival rates.
While drug treatments focus on achieving specific clinical targets and increase survivorship, they do not always equate to improved quality of life for patients. Whereas standalone digital solutions or digital therapeutics (DTx) may improve patients’ wellbeing but have no impact on survival rates. It’s the combination of the two-drug treatment and a digital solution – that increases the likelihood of patients surviving and can lead to a better quality of life.
There are several digital health solutions already on the market that build on research in the space to offer a holistic, needs-specific approach to cancer treatment.
One example is the NCI PRO-CTCAE (STAR) study, which prompts nurses to respond to patients whenever one of 12 patient-reported symptoms worsens significantly.
Elsewhere, the COMPASS eHealth app builds on PRO data by using sensors and heart rate monitors to capture and analyze patient data, facilitating speedy intervention if required.
There’s certainly potential to further improve home monitoring by detecting biomarkers with sensors and capturing data with digital solutions to provide better feedback and more prompt support for disease progression.
We’ve seen the potential and impact of digital tools across many therapy areas, and oncology is no exception.
But the extraordinary circumstances we find ourselves in require new, innovative, more impactful solutions that provide further functionalities on top of educating patients and gathering data.
Tools that combine with pharmaceutical care to provide a holistic, needs-based approach to treatment, at the different stages of a cancer patient’s journey, offer the best care and address all the different issues they may face in course of their illness.
Not only will increased focus and investment in this area help pharma and healthcare professionals provide the best treatment possible, it will enable pharma to remain at the forefront of oncology treatment and research, too, ensuring they lead the pack and differentiate from the competition.
By Kevin Hanley, MD, Clinical Engagement Director, S3 Connected Health