Effectiveness of Electronic Patient-Reported Outcomes in Patients with Cancer Undergoing Immunotherapy: A Real-World Retrospective Study

Background Immune checkpoint inhibitors (ICIs) are essential in the treatment of advanced cancers; however, they can cause severe immune-related adverse events (irAEs). This retrospective study investigated the effectiveness of electronic patient-reported outcomes (ePROs) in monitoring the symptoms of patients with advanced cancer undergoing ICI therapy. Methods We retrospectively reviewed the medical records of patients with advanced cancer who received ICIs at the Komatsu Municipal Hospital between June 2019 and March 2024 following the introduction of ePROs. Results A total of 168 patients were included, with 43 in the ePRO group and 125 in the conventional care group. The incidence of grade ≥ 3 irAEs was significantly lower in the ePRO group than in the conventional care group (7% vs. 21%; P = 0.039). Multivariate analysis showed that the use of ePROs was significantly associated with fewer emergency visits (odds ratio [OR]: 0.22, P < 0.001) and hospitalizations (OR: 0.36, P = 0.027). Additionally, patients in the ePRO group demonstrated significantly longer progression-free survival (PFS) and overall survival (OS) than those in the conventional care group (median PFS: 10.8 vs. 4.8 months, hazard ratio (HR): 0.50, P = 0.003; median OS: not reached vs. 17.0 months, HR: 0.40, P = 0.010). Conclusion Implementation of ePROs was associated with clinical benefits in patients with advanced cancer receiving ICIs therapy. Our findings suggest that ePRO-based symptom monitoring may contribute to safer and more effective immunotherapy in real-world oncology practice. Further studies with larger cohorts are needed to confirm these findings.