Survey via app © Rhön Foundation
G-BA recommends making Charité treatment concept available to all statutory health insurance policyholders
Berlin, 6 August, 2026
Regularly asking patients with metastatic breast cancer about their well-being via an app—and responding promptly to their input—can alleviate the debilitating fatigue they experience and make their daily lives easier. Researchers from Charité – Universitätsmedizin Berlin and the German Cancer Society (DKG) demonstrate this in a study published today in the journal *JAMA Oncology*. The study is the result of the “PRO B” Innovation Fund project, which was implemented in collaboration with the health insurance funds BARMER, DAK-Gesundheit, and mkk – meine krankenkasse. Based on the positive results, the Federal Joint Committee (G-BA) recommends incorporating this new treatment approach into standard care.
Around 68,000 women in Germany are living with metastatic breast cancer—meaning the tumour has spread to other organs. At this stage, the cancer is no longer curable; however, modern therapies allow the disease to be temporarily controlled and life expectancy to be extended by several years. Some women are even able to continue working. Yet, today’s therapeutic options also bring challenges.
“New medications often no longer need to be administered in the clinic but can be taken at home,” says Prof. Maria Karsten, Senior Physician at the Charité Breast Centre and initiator of the PRO B project. “As a result, we see patients less frequently in the clinic, and our medical oversight has become somewhat fragmented. To bridge this gap and provide close monitoring despite the physical distance, we developed the digital treatment concept PRO B.”
Close monitoring despite distance
At the heart of the PRO-B approach is an app that asks women up to 52 structured questions once a week regarding their symptoms, daily life, and emotional state. Examples include “Did you experience pain?”, “Were you too tired to carry out your usual activities?”, or “Did you experience shortness of breath?”. An algorithm then analyses the responses and immediately reports any relevant changes to the treatment team. The notified team calls the patients within 48 hours to determine whether—and if so, what—measures need to be taken.
“During these calls, we might discuss adjusting the dosage of anti-nausea medication or offer practical tips for managing various symptoms,” explains Maria Karsten. “However, we can also detect serious side effects more quickly—such as those signalled by a seemingly harmless symptom like fatigue—and immediately ask the patient to come into the clinic.”
Less exhaustion, greater fitness, and fewer hospital stay
A nationwide study has now enabled the research team to demonstrate that this combination of close digital monitoring and targeted personal care improves the daily lives of those affected. The study involved 52 breast cancer centres, with treatment teams monitoring 909 patients—aged 19 to 81—with metastatic breast cancer over the course of a year. Roughly half of the women received care based on the PRO-B concept alongside their drug-based tumor therapy. The other half did not receive the full PRO-B care; instead, they were asked about their well-being only once every three months and were not contacted by the treatment team.
The result: Patients in the PRO-B group reported significantly less fatigue—a state of physical, emotional, or mental exhaustion that can severely limit daily life. They also rated their physical functioning more highly and required hospital treatment less frequently.
A weekly safety net
“These are effects that have a noticeable impact on the patients’ daily lives; the women are more capable and better able to manage their lives,” emphasizes Maria Karsten, who led the study. “We even have indications that the PRO-B concept extends the remaining lifespan of some patients. We achieve all this not through a new drug, but simply by regularly and systematically inquiring about the women’s well-being and responding to it.” The verdict from the patients in the PRO-B study group is clear: in a survey conducted after the study concluded, more than 90 percent expressed a desire for the new treatment concept to become part of routine care.
Stephanie Neumann-Johnston is one of the patients who participated in the PRO-B study. “I feel like the app has saved my life several times,” says the 51-year-old. “There are so many situations and incidents that are hard to interpret, and you have so many questions. In the app, I can look up typical problems and find professionally verified information—for example, on fatigue. This allows me to help myself, even on weekends. And the personal contact provides me with emotional and medical support. For instance, I can clarify immediately whether I’m allowed to take fever-reducing medication or get an assessment of my situation: Should I go to the emergency room with these symptoms or not? The app takes a huge weight off my shoulders.”
“ida” on the path to routine care
Based on the medical results and a health-economic analysis, the Federal Joint Committee (G-BA) recommended in June that the PRO-B treatment concept be transitioned into routine care. This means that, in the future, all patients with statutory health insurance will be able to access this new form of care once diagnosed. “This recommendation must now be implemented as quickly as possible,” emphasizes PD Dr. Christoph Kowalski, a department head at the German Cancer Society and co-author of the study. “If a new care model offers medical and economic benefits, we should not withhold it from the most severely ill women.”
To offer PRO-B care to their policyholders even before its formal integration into standard care, the health insurance funds participating in the project are planning a further development that is expected to enable the routine use of the PRO-B concept for affected women starting in the autumn. Going forward, this new model of care will be continued under the name “ida” by Maria Karsten and her team.
*Karsten MM et al. Electronic PRO monitoring with alert-based interventions in metastatic breast cancer: Primary results of the multicenter randomized PRO B trial. JAMA Oncol 2026 Aug 06. doi: 10.1001/jamaoncol.2026.2661
About PRO B
The PRO B project (Patient-Reported Outcomes in Breast Cancer) received approximately 4.8 million euros in funding between 2020 and 2024 from the Innovation Committee of the Federal Joint Committee (G-BA). The project is led by Prof. Maria Karsten from Charité; consortium partners include BARMER, mkk – meine krankenkasse, DAK-Gesundheit, the German Cancer Society (DKG), and OnkoZert GmbH.
About Breast Cancer
Breast cancer is the most common cancer among women in Germany; approximately one in eight women will develop the disease during her lifetime. Worldwide, breast cancer is the leading cause of cancer-related death.
Despite therapeutic advances, 30 percent of women with early-stage breast cancer and up to 70 percent of those with lymph node involvement will eventually develop distant metastases, which generally render the breast cancer incurable. Metastatic breast cancer is associated with a significant health burden and reduced quality of life. The goal of treatment in such cases is to prolong life while maintaining the best possible quality of life. About Innovation Fund Projects
Since 2016, the Federal Joint Committee (G-BA) has been mandated to fund new forms of care that go beyond standard care, as well as projects focused on health services research. The aim is to improve the quality of healthcare in Germany. The Innovation Fund is financed by resources from statutory health insurance funds and the Health Fund.
SOURCE: Joint press release by Charité, DKG, BARMER, DAK-Gesundheit, and mkk – meine krankenkasse