University of Oulu

Iivanainen, S., Alanko, T., Peltola, K. et al. J Cancer Res Clin Oncol (2019) 145: 765.

ePROs in the follow-up of cancer patients treated with immune checkpoint inhibitors : a retrospective study

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Author: Iivanainen, Sanna1; Alanko, Tuomo2; Peltola, Katriina2;
Organizations: 1Department of Oncology and Radiotherapy, Oulu University Hospital (OYS), MRC Oulu, P.B. 22, 90029 Oulu, Finland
2Docrates Cancer Center, Helsinki, Finland
3Kaiku Health Oy, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2.3 MB)
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Language: English
Published: Springer Nature, 2019
Publish Date: 2019-05-06


Purpose: Patient-reported outcome (PRO) follow-up has been shown to improve quality of life (QoL) and survival of cancer patients receiving chemotherapy. Kaiku Health application is a web-based electronic PRO (ePRO) tool which is designed for follow-up of cancer patients receiving immune checkpoint inhibitors (ICI). Purpose of the current study is to investigate whether symptoms collected by Kaiku Health ePRO tool on cancer patients receiving immune checkpoint inhibitors (ICI) follows to symptoms reported in clinical trials and whether coupling of specific symptoms does occur.

Methods: We retrospectively collected data on symptom timing and severity, and QoL of patients followed with Kaiku Health IO module in two Finnish cancer centers between 2017 and 2018. Kaiku Health IO module consists of 18 adaptive questions, which assess the presence and severity of symptoms. Patients were requested (via e-mail) to fill online symptom questionnaires with 3–7 day interval and QoL questionnaires (QLQ-C30) with 1–2 month interval.

Results: The IO module was used to follow 37 patients who had filled in total 559 symptom questionnaires. There was good adherence to ePRO follow-up with a median of 11 questionnaires filled per patient. The reported symptoms and their severity follow closely what has been seen in clinical trials investigating ICIs. Correlation analysis of the symptoms showed the strongest positive correlations between itching and rash; nausea and vomiting, decreased appetite, or stomach pain; cough and shortness of breath.

Conclusions: The results of the current study suggest that real-world symptom data collected through the ePRO application on cancer patients receiving ICI therapy aligns with the data from clinical trials. Correlations between different symptoms occur, which might reflect therapeutic efficiency, side effects, or tumor progression. These correlations should be further investigated with data coupled to clinical outcomes.

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Series: Journal of cancer research and clinical oncology
ISSN: 0171-5216
ISSN-E: 1432-1335
ISSN-L: 0171-5216
Volume: 145
Issue: 3
Pages: 765 - 774
DOI: 10.1007/s00432-018-02835-6
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: Open access funding provided by University of Oulu including Oulu University Hospital. Study was funded by Oulu University. Kaiku Health employees were involved in the data acquiring and analysis.
Copyright information: © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.