The paper in this issue by Giordano  describes the current state of mobile health in oncology, a big part of which are electronic patient-reported outcomes. The most impressive results are reported in two prospective randomized trials by Basch et al.  and Denis et al.  demonstrating a survival benefit with electronic patient-reported outcome measures (ePROMs).
Two other examples of recent significant trials in lung cancer include the IMPOWER 133 trial  and the PACIFIC trial , both introducing immunotherapeutic agents to lung cancer. For many, these trials are shaping new standards of care. The IMPOWER 133 trial demonstrated an improvement in overall survival from 10.3 months to 12.3 months with the addition of atezolizumab to chemotherapy in stage IV small-cell lung cancer. The PACIFIC trial demonstrated an overall survival benefit with durvalumab in patients with stage III, unresectable non-small-cell lung cancer without disease progression after concurrent chemotherapy. The placebo arm had a median overall survival (mOS) of 28.7 months, while the mOS for the durvalumab arm has not yet been reached: 34.7 months or more (95% confidence interval) .
The survival benefit from the ePROM trials is no less impressive, with an increase in mOS from 26 to 31.2 months when used for adverse event monitoring during chemotherapy  and an increase from 12 to 19 months when used in follow-up . Does this make ePROMs standard of care? While it is simple to argue that the advantage of the ePROM arms may stem from insufficient care in the control arm, these control arms represent reality. We can always improve patient communication and optimize follow-up independently of the use of ePROMs; however, these interventions have demonstrated a meaningful impact on patients’ lives. Additionally, we can guess which interventions might win in cost-efficiency analyses.
Whether we are ready to declare the use of ePROMs a standard of care is up for debate – several barriers and limitations are addressed in the paper by Giordano . Going forward, we will need to learn how to apply this new modality and understand how to compare and combine approaches. Guideline committees will need to broaden their searches and future guidelines will be incomplete if these aspects are ignored.
The paper by Giordano  describes the current state of ePROMs and the results from the positive ePROM trials underline their importance.
The author has no conflicts of interest to declare.