Examining Patients’ Opinions on NavDx During Head and Neck Cancer Surveillance: An Exploratory Study

Introduction: Circulating tumor DNA (ctDNA) assays for HPV+ driven oropharyngeal cancer, such as NavDx, are now available as molecular surveillance tools. Although blood-based biomarkers (liquid biopsy) are increasingly used in precision oncology, there are currently no studies on patient opinion on NavDX in head and neck cancer surveillance, and no formal guidance on usage. Evaluating the patient attitude and experience is important when incorporating new technology and tests into their care.

Methods: Qualitative thematic analysis was conducted to examine an open-ended questionnaire completed by patients undergoing surveillance for oropharyngeal HPV+ cancer after receiving their NavDx test results. The open ended survey was given from June 2023 to October 2023. Patient responses were extracted and imported into the qualitative data analysis software package ATLAS.ti.

Results: Of the 49 patients who participated, qualitative analysis identified the following major themes: convenience, cost, and validity. During analysis, it was noted that participants were comfortable with having a blood biopsy performed as part of their surveillance, with one patient reporting “I have more confidence that NavDx is not a false negative compared to my scans.” Many commented about wanting NavDx as part of their regular blood panel, and one patient requested NavDx to be performed routinely as in men’s PSA citing it as “less intrusive and expensive than other diagnostic procedures.” Approximately, 20% of patients commented or inquired about pricing of NavDx.

Conclusions: Open-ended questions following NavDx for molecular surveillance demonstrated an overall positive patient perception of the test highlighting validity and convenience of the test. A possible deterrent identified in analysis included out-of-pocket costs to patients.