Remote monitoring of oncological patients with skin toxicity: immediate and long-term research results on optimizing the approach to management tactics

Relevance. Today, one of the promising areas of personalized oncology in the treatment of malignant neoplasms is targeted and immunotherapy. However, despite its effectiveness, dermatological adverse events are observed while taking these drugs. In severe cases, skin toxicity can lead to poor adherence to treatment and discontinuation of basic therapy, affecting survival and quality of life.

The aim of the study. Assessment of the impact of remote monitoring on the results of correction of skin toxicity, quality of life and 2-year progressionfree survival in cancer patients receiving EGFR inhibitors and immunotherapy.

Materials and methods. The study included 220 patients aged 18–70 years with manifestations of skin toxicity on the background of targeted and immune therapy, divided into 2 equivalent groups. The main group of patients received support therapy as part of remote monitoring using the Healthy Skin patient support program, the comparison group consisted of patients receiving outpatient consultations.

Results. The results of the multifactorial analysis confirm the statistically significant influence of the group and the number of consultations on the improvement of the 2-year progression-free survival rate by an average of 12 weeks in the online follow-up group compared with traditional outpatient consultations, as well as a decrease in the BSA, pruritus and DIC indices (with a 95 % probability) in the study group. After 4 weeks, an improvement in the pruritus index was recorded in 85.5 % of patients and no deterioration in the first group compared to the second, where deterioration in the index was detected in 31.8 % of patients. A close correlation was also established between the severity of skin toxicity and its negative impact on the quality of life of oncology patients, which is confirmed by the data from the DLQI and SF-12 questionnaires. The developed method made it possible to quickly achieve a stable condition of the skin without episodes of aggravation, which made it possible to continue anticancer therapy in full without interruptions and cancellations against the background of preserved quality of life, compared with the second group, where cases of interruption/cancellation of therapy were due to aggravation of skin toxicity.

Conclusion. Most modern cancer treatment methods are accompanied by adverse events, often affecting the skin. Correction of skin toxicity is a priority for oncology patients, as it is a complex interdisciplinary problem. Remote monitoring is an effective clinical tool, representing an accessible form of communication between the doctor and the patient, facilitating timely control of skin toxicity. The introduction of telemedicine technologies can minimize severe forms of skin toxicity, maintain a decent level of quality of life and reduce the incidence of interruption or termination of therapy, increasing survival of cancer patients.

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