PURPOSE: Remote symptom monitoring of patients with cancer has previously shown potential for improving clinical outcomes. This study aimed to evaluate the effects of remote symptom monitoring in patients with lung cancer after palliative induction treatment. METHODS: In a Danish multicenter randomized controlled trial, patients were randomly assigned 1:1 to remote symptom monitoring (intervention arm) added to standard of care versus standard of care (control arm). Key eligibility criteria were stage III-IV lung cancer (small cell lung cancer and non–small cell lung cancer), Eastern Cooperative Oncology Group performance status ≤2, and no sign of disease progression after initial induction treatment. Patients in the intervention arm completed a weekly electronic questionnaire, assessing 14 common symptoms related to lung cancer. When a patient reported a severity exceeding a predefined threshold, the patient was subsequently contacted by phone to address potential clinical needs. Symptom monitoring was discontinued after progression. The primary outcome was overall survival (OS). Secondary measures included assessment of health-related quality of life (HRQoL). RESULTS: Of 494 randomly assigned patients, 240 were assigned to the intervention arm and 254 were assigned to the control arm. At a median follow-up of 3.5 years, symptom monitoring did not significantly improve OS compared with standard care (hazard ratio [HR], 0.93 [95% CI, 0.75 to 1.16]; P = .53). Exploratory subgroup analyses indicated improved survival for patients treated with carboplatin/vinorelbine (HR, 0.67 [95% CI, 0.45 to 0.98]; P = .04) and in departments with previous implementation of patient-reported outcomes (HR, 0.66 [95% CI, 0.44 to 0.98]; P = .04). HRQoL analyses did not reveal clinically meaningful effects. CONCLUSION: In the Danish health care system, remote symptom monitoring did not improve OS but led to modest improvements in HRQoL for patients with advanced lung cancer.

De novo small-cell neuroendocrine prostate cancer (SCNE PC) is a rare and highly aggressive subtype of prostate cancer with limited treatment options. BRCA2 alterations may increase sensitivity to platinum-based chemotherapy and PARP inhibition; however, evidence regarding their clinical relevance in SCNE PC is limited. We present two cases of de novo SCNE PC with distinct BRCA2 alterations. Both patients presented with a similarly extensive disease burden and initially received carboplatin and etoposide (CE), but their clinical courses differed markedly. Patient 1 developed brain metastases three months after completing six cycles of CE and died shortly after rechallenge with CE. In contrast, Patient 2 responded to repeated CE rechallenges, followed by short-term disease control with topotecan and 18 months of disease control with the PARP inhibitor olaparib. He subsequently developed leptomeningeal carcinomatosis and died shortly thereafter, with an overall survival of 5 years and 8 months. These cases illustrate the highly aggressive clinical course of de novo SCNE PC. Despite the potential predictive value of BRCA2 alterations, they may be associated with a higher incidence of brain metastases.