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Patient perceptions underlying ctDNA molecular surveillance for HPV(+) oropharyngeal squamous cell carcinoma.
Bastien, Amanda J; Ng, Jewel; Cong, Iris; Garcia, Jonathan; Walgama, Evan S; Luu, Michael; Jang, Julie K; Mita, Alain C; Scher, Kevin S; Moyers, Justin T; Clair, Jon Mallen-St; Maghami, Ellie; Chen, Michelle M; Zumsteg, Zachary S; Ho, Allen S.
Afiliação
  • Bastien AJ; Division of Otolaryngology-Head and Neck Surgery, Dept. of Surgery, Cedars-Sinai Medical Center, 8631 West Third St., Suite 915E, Los Angeles, CA 90048, United States.
  • Ng J; Division of Otolaryngology-Head and Neck Surgery, Dept. of Surgery, Cedars-Sinai Medical Center, 8631 West Third St., Suite 915E, Los Angeles, CA 90048, United States.
  • Cong I; Division of Otolaryngology-Head and Neck Surgery, Dept. of Surgery, Cedars-Sinai Medical Center, 8631 West Third St., Suite 915E, Los Angeles, CA 90048, United States.
  • Garcia J; Division of Otolaryngology-Head and Neck Surgery, Dept. of Surgery, Cedars-Sinai Medical Center, 8631 West Third St., Suite 915E, Los Angeles, CA 90048, United States.
  • Walgama ES; Division of Otolaryngology-Head and Neck Surgery, Dept. of Surgery, Cedars-Sinai Medical Center, 8631 West Third St., Suite 915E, Los Angeles, CA 90048, United States; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
  • Luu M; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States; Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
  • Jang JK; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States; Department of Radiation Oncology, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
  • Mita AC; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States; Division of Medical Oncology, Dept. of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
  • Scher KS; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States; Division of Medical Oncology, Dept. of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
  • Moyers JT; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States; Division of Medical Oncology, Dept. of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States; The Angeles Clinic and Research I
  • Clair JM; Division of Otolaryngology-Head and Neck Surgery, Dept. of Surgery, Cedars-Sinai Medical Center, 8631 West Third St., Suite 915E, Los Angeles, CA 90048, United States; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
  • Maghami E; Dept. of Surgery, City of Hope National Medical Center, 1500 E Duarte Rd, Duarte, CA 91010, United States.
  • Chen MM; Dept. of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Stanford, CA 94305, United States.
  • Zumsteg ZS; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States; Department of Radiation Oncology, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
  • Ho AS; Division of Otolaryngology-Head and Neck Surgery, Dept. of Surgery, Cedars-Sinai Medical Center, 8631 West Third St., Suite 915E, Los Angeles, CA 90048, United States; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
Oral Oncol ; 156: 106894, 2024 Sep.
Article em En | MEDLINE | ID: mdl-38909394
ABSTRACT

OBJECTIVE:

Circulating tumor DNA assays have robust potential as molecular surveillance tools. They may also exacerbate patient distress without improving outcomes. We investigate patient acceptability of a validated ctHPVDNA assay (NavDx) during cancer surveillance for HPV(+) oropharyngeal cancer (OPC).

METHODS:

Consented HPV(+) OPC participants completed the NCCN Distress Thermometer, the Hospital Anxiety Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General (FACT-G) scale both (1) before NavDx blood draw, and (2) after results were provided. Patients then completed a series of focused questions related to their perceptions of the assay.

RESULTS:

Overall, 55 patients completed the study, with 98.2 % showing no recurrence. For the NCCN Distress Thermometer, median patient distress decreased (2.0 (IQR 1-5) vs. 1.0 (IQR 0-3)) (p < 0.001) in association with NavDx. Using scores ≥ 4 as a cutoff point to define clinically elevated distress, scores also improved (36.4 % vs. 18.2 %, p = 0.031). For HADS, anxiety significantly improved (5.0 (IQR 2.0-7.0) vs. 3.0 (IQR 1.0-6.5)) (p = 0.037), but not depression (3.0 (IQR 1.0-7.0) vs. 3.0 (IQR 1.0-6.5)) (p = 0.870). FACT-G scores showed no substantial differences. On survey questionnaires, 95.5 % of patients believed the test to be helpful, and 100 % felt "somewhat" or "extremely" confident in the assay as a monitoring tool. While 59.1 % felt that it reduced anxiety, 88.4 % concordantly felt that it did not introduce anxiety.

CONCLUSION:

ctHPVDNA as a molecular surveillance tool reduced distress levels in HPV(+) OPC patients, with notably high patient confidence in the approach. Further investigation is warranted to judiciously incorporate this emerging modality in surveillance guidelines.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Orofaríngeas / DNA Tumoral Circulante Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Orofaríngeas / DNA Tumoral Circulante Idioma: En Ano de publicação: 2024 Tipo de documento: Article