New results from an Alliance Foundation Trials (AFT) study reveal that a simple weekly electronic symptom check-in with care team, significantly improves the quality of life for individuals undergoing treatment for advanced cancer. The study found that the biggest improvements were seen among patient groups that have historically faced the greatest barriers to care, including Black patients and individuals with less formal education.
The findings, published in JCO Oncology Practice , show that using remote check-ins help bridge communication gaps between patients and their treatment teams, offering a powerful way to make cancer care more effective.
“When novel technologies are developed, there is a risk that they might leave historically underserved groups behind, widening rather than reducing health disparities,” said Victoria Blinder, MD, breast medical oncologist at Memorial Sloan Kettering Cancer Center and senior author of the study. “Here, we see that the opposite seems to be happening. Rather than exacerbating disparities, implementation of remote symptom monitoring is bridging an important communication gap and improving healthcare access for underserved groups.”
While researchers already know that keeping a close eye on side effects helps cancer patients feel better and stay more active, this study looked at how different groups can benefit from remote symptom technology where patients can self-report issues to their treatment team in real-time.
AFT-39 , the PRO-TECT ( P atient R eported O utcomes T o E nhance C ancer T reatment) trial, enrolled 1,191 adults with advanced cancer across 52 community oncology clinics in the United States. Half of the patients received their usual care, while the other half filled out a brief symptom survey every week from home. To ensure internet access wasn't a barrier, patients could choose to fill out their surveys online using a smartphone or computer, or over a standard telephone using an automated, voice-prompted system. If a patient reported severe or worsening side effects, an alert went directly to a nurse on their care team for intervention.
“By giving people a simple way to report health issues during cancer treatments, we were able to bypass common hurdles like communication gaps or clinician bias, sending patient concerns straight to the medical team for quick action, delaying emergency department visits and improving outcomes, said Allison M. Deal, MS, a Senior Biostatistician at the UNC Lineberger Comprehensive Cancer Center and a lead author of the study.
After three months, the group using the weekly check-ins showed major improvements in both overall symptom control and daily physical function compared to those receiving usual care. When looking at specific groups, the benefits were notable:
The researchers say that widespread use of these routine symptom check-ins could be a gamechanger for lowering healthcare disparities and ensuring every cancer patient gets the responsive care they need. In addition, the tools were found to reduce or delay emergency department visits for patients, which are known to cause financial and emotional stress for patients and their families.
“Our results suggest that remote monitoring may provide underserved cancer patients with a new avenue to communicate concerns that might go underrecognized in routine practice,” said Ethan Basch, MD, M.Sc., study chair of AFT-39 and the Richard M. Goldberg Distinguished Professor of Medicine at the University of North Carolina School of Medicine. “Broad implementation of these systems may represent an effective and highly practical strategy to advance health equity. Future studies should test technology with more general patient audiences.”
In addition to the University of North Carolina, authors of the study included clinicians from the Alliance for Clinical Trials in Oncology, Duke University School of Medicine, HealthPartners/Park Nicollet, Johns Hopkins School of Medicine, Mayo Clinic, Michigan State University College of Nursing, Northwestern University Feinberg School of Medicine, Patient and Partners, and the University of Rochester Medical Center.
The authors are grateful to the patients for their participation in this study. This trial was supported by the Alliance Foundation Trials (AFT) and the Patient-Centered Outcomes Research Institute (PCORI). The study made use of technology systems provided by the Patient-Reported Outcomes Core at the Lineberger Comprehensive Cancer Center of the University of North Carolina, which is funded by National Cancer Institute Cancer and the University Cancer Research Fund of North Carolina.
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Reference: Benefits of Electronic Symptom Monitoring During Cancer Treatment by Age, Sex, Race, and Education (Alliance AFT-39), JCO Oncology Practice , DOI: 10.1200/OP-26-00015 .
Alliance Foundation Trials, LLC, is a research organization that develops and conducts cancer clinical trials, working closely with the Alliance for Clinical Trials in Oncology scientific investigators and institutional member network, research collaborators, and non-NCI funding sources. AFT seeks to fulfill the vision of the Alliance for Clinical Trials in Oncology to reduce the impact of cancer on people by uniting a broad community of scientists and clinicians from many disciplines committed to discovering, validating and disseminating effective strategies for the prevention and treatment of cancer. Current AFT studies are funded by industry collaborators and the Patient-Centered Outcomes Research Institute (PCORI).
The Alliance for Clinical Trials in Oncology is a national leader in advancing cancer research, uniting more than 25,000 cancer specialists at 112 main institutions and 1,400 affiliates across the U.S. and Canada. As part of the National Clinical Trials Network and a leading research base for the NCI Community Oncology Research Program, the Alliance conducts pioneering, practice-changing clinical trials that improve outcomes and reshape standards of care. Our work has led to multiple FDA approvals, influenced national guidelines, and produced hundreds of high-impact publications. More than 40,000 participants have taken part in Alliance studies, and our growing biospecimen repository now includes more than 1.5 million samples, collected over the past 30 years. Learn more at allianceforclinicaltrialsinoncology.org.
JCO Oncology Practice
Randomized controlled/clinical trial
People
Benefits of Electronic Symptom Monitoring During Cancer Treatment by Age, Sex, Race, and Education (Alliance AFT-39)
12-May-2026
Supported by Alliance Foundation Trials (AFT), PCORI IHS-1511-33392; https://acknowledgments.alliancefound.org. The trial made use of technology systems provided by the Patient-Reported Outcomes Core (PRO Core; pro.unc.edu) at the Lineberger Comprehensive Cancer Center of the University of North Carolina, which is funded by National Cancer Institute Cancer Center Core Support Grant No. 5-P30-CA016086 and the University Cancer Research Fund of North Carolina. The LCCC Bioinformatics Core provides the computational infrastructure for the PRO Core system. Yashasvini Sampathkumar’s time was supported by the National Cancer Institute research training grant (T32CA275764).