Improved health-related quality of life (HR-QOL) with use of an online mindfulness tool in patients with metastatic renal cell carcinoma (mRCC) receiving immunotherapy (IO).

660 Background: Previous randomized studies have shown the benefit of interventions to increase mindfulness in multiple cancer types, including prostate cancer (Chambers et al JCO 2017), but limited data exists in mRCC. We sought to determine the effect of an app-based mindfulness intervention on anxiety, fear of cancer progression (FCR), fatigue and HR-QOL in this population. Methods: Eligible patients had mRCC, were receiving IO, had measurable symptoms of anxiety or FCR, had a smartphone with internet access and had not participated in a mindfulness program in the past 5 years. Patients were recruited in Brazil across 7 private centers and one academic center in the US. We evaluated the Mindfulness-Based Cancer Survivorship Journey, a program within the Am Mindfulness smartphone app (AmDTx). Patients used AmDTx for 20-30 minutes each day for a minimum of 4 days per week over a period of 4 weeks. Patients were assessed at baseline (T1) and at weeks 2 (T2), 4 (T3) and 12 (T4) using the PROMIS-Anxiety, FCR-7, Brief Fatigue Inventory (BFI), and Functional Assessment of Chronic Illness Therapy-General (FACT-G). RM-ANOVA was used to test the effect of time on symptoms and on HR-QOL. Results: A total of 41 patients were recruited; median age was 59 (range, 36-79) and patients were predominantly male (70%), white (61%), married (75%) and well educated (65% had at least a college degree). Most patients were receiving nivolumab/ipilimumab (44%), nivolumab (22%) or axitinib/pembrolizumab (9%). Symptoms of anxiety significantly decreased from 21.6 + 4.8 to 12.5 + 5.1 (P=0.001). Similar findings were found for FCR (MT1=21.4 to MT4=13.5, P=0.001) and fatigue (MT1=32.0 to MT4=19.4, P=0.001). Notably, HR-QOL increased from 81.1 + 13.4 to 92.7 + 14.9 (P=0.001). No significant differences were identified based on disease characteristics or type of therapy. Conclusions: The current study suggests that smartphone-based mindfulness intervention could improve HR-QOL and decreased FCR, anxiety and fatigue. This low-cost, easily accessible intervention may provide an important alternative to in-person psychosocial support for patients with mRCC and should be assessed in randomized trials in this disease. Funding: Kure It Cancer Research: 2020 Barry Hoeven Memorial Kidney Cancer Research Grant (PI: C D Bergerot).