Blood test to detect HPV+ SCC - NavDX
I haven't read a lot of the posts.. however, in the ones that I have read, I haven't seen anything about the NavDX blood test. I just went in for my 9 month post treatment check-up at USC, and my ENT had ordered blood drawn for the NavDX test so that results would be in for my check-up appt. While my initial cancer was in my left tonsil/left lymphnodes, this blood test detects anything in the body with, according to my ENT, a 95% reliability rating. So, if the results are above a 0.0, there is a 95% chance that there is HPV+ cancer somewhere in the body - at which point a scan would be initiated (similar to a PSA # for prostate cancer detection). Having this test does offer more insight into my current status vs just a visual inspection of the prior-affected areas... and may, hopefully, limit the number of future scans that may be ordered in the future. He recommended that I do this test every 6 months.
If anyone else has any experience or knowledge with the NavDX that can shed more light on its effectiveness/reliability, I would be interested in learning as much as I can about it.
Thanks!
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Well, Luvn this is the first I have ever heard of it. I am not sure if this test will take off and be a standard of care or not. Apparently, it will show that cancer is still there down to the cellular level but they can't localize it because it hasn't settled somewhere and made a tumor big enough to be detected. It may help to know if the possibility of cancer is there but I don't see any action that can be taken unless they could then maybe give you rounds of chemo to eradicate it from the bloodstream. I think this is a new concept and not widely used yet but has great possibilities.
Quote from an article--The Ohio State University Comprehensive Cancer Center
Refinement and research
The Head and Neck Surgery team was immediately intrigued by NavDx’s potential.
“For a small percentage of patients, we might know the cancer is there, but we don’t know where it is,” Dr. Rocco says. “The test tells us it is still there, but we can’t localize it.”
The most sensitive imaging available to detect cancer is the PET CT scan. If that advanced imaging shows no evidence of disease but the NavDx test detects cancer DNA, what’s the best course of action?
“We’re trying to figure it out now,” Dr. Rocco says. “This is unfolding in real-time.”
Doctors must decide if they should employ watchful waiting, schedule regular screenings or start systemic treatment.
Studies are underway to improve the test’s performance status. Dr. Haring says the goal is to get the test to detect HPV cancer DNA in 100% of patients. When that happens, science will be closer to potentially using this blood test as a screening test for HPV cancer, in the same way a colonoscopy or mammogram is employed.
Here is a link to the article which explains it pretty well--
It certainly looks like one more tool that can be used to help fight this evil disease.
Also found this article on it from June 23, 2021--also explaining it quite well--
It also explains it quite well and here is a quote from it from a doctor--
"Our goal was to develop a test that could tell us whether a treatment is likely to work after a single cycle."
Take Care God Bless-Russ
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Thanks for the info. Although it has some limitations, I think something like this gives the acronym NED a more-definite meaning. Also, if it can potentially reduce the number of scans that are needed, sign me up. When I was first diagnosed, I really didn't care (or, didn't give much thought to) what they did to me. I was up for any scan, x-ray, radiation bombardment, etc. that my care team wanted to throw at me to be aggressive in fighting it. However, now that surgery/treatments are all done, I would love to not have to expose my body to more of that activity unless it is absolutely necessary.
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While I can’t actually “shed more light on its effectiveness/reliability” I can tell you about my experience with the test and it’s results.
I had my primary treatment at UNC-CH where my doctors had a role in the development /testing of this technology. Before my radiation and chemo I had my blood tested and it came back with a score of 288, indicating a presence of significant levels of cancer…6 months later, after treatment, I went in for my petscan and had another NavDx test. The bad news was that they found hot spots in my lungs, indicating that it had indeed metastasized there, and the blood test came back with a score of 88. So the scan and the blood test confirmed each other.
I then began a trial based on a Keytruda infusion every 3 weeks along with some injections of an element of the HPV vaccine. I responded very well to the treatment based on the CT scans I got every 9 weeks and after another 6 months passed I had my blood tested again and it went down to a score of 11! The correlation continued.
3 weeks ago I was tested again and it came back negative! Rejoice!!!
At my next treatment which includes CT scans, just after thanksgiving, we will send my blood in again and hope to get another negative result. At that point if it’s negative again 🤞🏼and the CT scans continue to look good, we will conclude that I am cancer free. At that point we will have a discussion about possibly discontinuing treatment. If it’s positive then the rollercoaster continues…..
If all goes well then maybe instead of getting scanned every 3 months looking for hot spots perhaps I can just get a NavDx blood test periodically.
NavDx is, imo, a great tool that can help detect cancer earlier, it can tell you if the treatment plan is working earlier, and can be a post treatment process that is more accurate and less invasive and costly than regular scans. But I’m “just a guy in a diner” who’s had 🤞🏼cancer….I’m not an expert at all.
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Not sure I can shed light, but my doctors at Johns Hopkins are enthused about this NavDX test as it appears to be highly reliable. I can tell you what it has done for me. At early stages of treatment for HPV +16 for throat (tonsil) and neck cancer (Stage II, nearly Stage III), my score was 6473 (very high). That was in August 2021. Now, a year and a month after the end of treatment, after 35 radiation treatments and 6 of the 7 prescribed chemo sessions, two, 8-day hospitalizations for life and death situations, 4 months on a PEG tube, a massive abscess in the neck that nearly killed me, dental treatments and bills for many teeth destroyed by radiation, and more than a quarter of million dollars in health care costs (mostly paid by insurance) and a hellish recovery period, the second NavDX test results just came in and the score was "not detected," which is the best form of negative there is. This is a huge relief and confirmation of the negative results on post-treatment CT scans and PET scans. After all this trauma, there may be real substance to the NED diagnosis. Maybe I can get more sleep now.
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I have also been "slow on the draw" with regards to MPennak's comment. Boy, I am thinking about copying that comment and sending it to my oncologist. My treatment docs are just diving into the NavDX pool... and don't quite yet know what to do with it. The current situation with me that has them confounded is that there is no scan evidence yet to pinpoint any actual cancer to treat... just an elevated number on a blood test. My oncologist said she can't place me in a trial until they know can detect cancer. So far, I have undergone a CT w/ contrast of the soft-tissue head/neck and the abdomen. Both of those were inconclusive.. showing nothing remarkable. There were some tiny, unidentified spots on my liver that she wanted looked at with an MRI w/ contrast. I just did that yesterday... and they came back as most-likey "small, hepatic cysts" which, according to what I have read, is something I might have had since birth. Everything else showed as "within normal limits". Next week, I have a full-body PET scan scheduled with a oncologist follow-up the next day after the scan. Hopefully, we can figure out some next steps between now and then. One interesting situation that should get resolved with all of this is that I may be able to find out if the daily, Joe Tippens protocol (fenbendazole) is effective against hpv+ SCC. I have been on the protocol since being diagnosed back in 2021. If I continue to show elevated levels of the dna in the blood on the NavDX, without any signs of actual cancer in the body, well.. I am not a doctor, but, I would probably continue with the protocol. If a recurrence is spotted.. then, I can conclude the protocol is ineffective in my case. Will keep you all posted as things happen. Also, another thing.. I underwent a colonoscopy last Friday for some blood in the stool.. and it was my 7-year check up. The doctor detected and removed two, large "polyps" that were sent off for biopsy... with no results yet. So, I got that going on as well. Whatever is happening in life... I just refer back to Matthew 27: "27 Can any one of you by worrying add a single hour to your life[a]?" Actually, I believe, with hpv+ scc, worrying is probably the worst thing we can do. So, I am just thankful for today... that I have Jesus in my heart... "34 Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own." Amen!
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I am not yet sure if this NavDX test is the breakthrough test of all tests to solve the cancer problem.
It seems to be able to let the doctors know that a patient has the possibility of getting cancer but to what percentage chance of them getting cancer I don't know. Such as Joe Smith's NavDX test shows that he has cancer cell remnants in his blood and he has 40% of getting cancer or getting a recurrence. It seems they still need to find the actual or an actual cancer or can the cancer remnants in the blood be treated?
It seems the test can indicate cancer or leftover remnants from a just-treated cancer and may indicate a possible recurrence.
NavDx is the first and only clinically validated circulating tumor-tissue–modified HPV (TTMV®) DNA blood test that aids in the detection of HPV-driven cancer. NavDx uses proprietary technology to quantify fragments of circulating TTMV HPV DNA, a unique HPV-driven cancer biomarker that cancer cells shed into the blood.
So if I understand correctly cancer cells shed a biomarker so if the biomarker is found you either have cancer somewhere or these are indications of cancer still in your body somewhere, from a recent cancer episode and even down to as small as cancer cells which are going to be too small to show on a CT scan or most likely a PET scan. So the possibility of cancer is there but it seems it has to develop in a place and be large enough to be detected.
Unless they can effectively treat cancer on a cellular level which would be great and I hope it can be done and with all cancers not just HPV-driven cancer.
Take care, God Bless All you good folks.
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It is a completely useful tool in the fight. It will save time, money radiation exposure and anxiety in many cases. Its fist fantastic use in OSCC fight was in therapy with chemo and Rads, frequent NavDX test show a clearance profile ( how fast is the cancer leaving). It defines a speed and or effectiveness of treatments. Treatments can be scaled based on this data (deescalation). I had surgical modality of treatment only no chemo or rads so the test becomes binary in my case, Positive or Negative. It will just be a couple of years and we will be viewing current imaging methods of cancer detection as stone age! Yes for the most part cancer needs to be localized or found before treatment, and this test will not locate it. However it will let many of us relax with a less complex surveillance program. With the misfortune of a positive test you can put a tight watch on your body with imaging and wage a treatment response as soon as it is localized! With a blood based genetic test you will be on target months before imaging alone and that is an absolute fact!
Good day to all and good health
Gordon
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I agree Gordon this NavDX test has very distinct possibilities to do much more and is in it's infancy right now I believe. I hope it fills many gaps and revolutionizes cancer detection and treatment. I hope they get it developed to find any kind of cancer Biomarkers in the blood not just HPV-related. That is one question in my mind, could they develop a test for all cancers? But if they can't it is good they can do it with at least one kind. One step at a time eradicating cancer. I am sure there are other groups out there and scientists working on cancer from many different angles with tests and drugs and hopefully one or a combination of many will lead us to get rid of the cancer threat to humankind and even for animals because I have known people who have lost some beloved pets over the years to cancer.
Take care, God Bless-Russ
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Okay, follow-up to the rising NavDX numbers. To recap, I had a "negative" result approx six months post treatment (surgery/cisplatin/radiation). Jan 17th, 2023, one year post treatment, ENT physical check was NED; however, a NavDX "positive" of 8... followed up by a "positive" of 78 a few weeks later. PET last night, and follow-up with oncologist this morning revealed a metastasis "spot" on my lower, right rib bone lit up in scan. When the oncologist pointed to the approximate spot, I mentioned that that was interesting... because I had been the doctor for a "pain" in that spot prior to any diagnosis of cancer in the head and neck. So, she went back and reviewed my first PET scan (pre-surgery and treatment) from back in Sept of 2021. Guess what? It was there as well... they had just missed it. The inital PET was poor resolution, and the spot was lightly "lit up". To explain the first "negative" of nearly zero on the NavDX last year, the oncologist thinks that the chemo probably knocked it down enough to almost get rid of it... but didn't clear it completely. As a result, it started growing again... thus, the rising numbers. So, good news is that there is no new metastasis. Also, she said that the location of this spot is ideal for curative, medium-dose radiation (possibly only 3-4 treatments) to zap that one spot. Followed up 3 months from now with another PET to check for effectiveness. All in all, I am pretty pleased. Thank God for the NavDX! Without it, I would be blissfully ignorant.... assuming I was NED. Instead, I am jumping on a treatment plan asap. Also, the colonoscopy biopsy came back "benign" (however, it is pre-cancerous). So, I go to a colonoscopy every 3 years now vs every 7 years.
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Russ, thank you! Okay, status update: after a consultation with the radiation doctor, he is going to use SBRT in 5 sessions to spot-treat the lesion on the rib. Going in for a 4D CAT Tuesday... about a week to 10 days to finalize the plan. So, in approx 2+ weeks, I should receive my first treatment. The only thing that is different is that there is no absolute diagnosis of recurrence. He said that getting an official diagnosis of that "spot" would require a CT-guided biopsy... then, he asked me if I preferred to get one prior to starting any treatment. That kind of threw me for a loop.. because, it seemed to leave things up in the air. I guess we are all trusting the NavDX technology, and the PET scan results to determine a spot to treat. I am sticking with my "gut"... which is to "just do it".
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I would say it sounds like a reasonable decision to go with your gut feelings and get this treated. Your doctor knows what he is doing and has had lots of experience treating cancer and it sounds like he feels confident in going this route. But keep in mind the only sure way to verify the area in question one way or the other is a biopsy but then you are dealing with another procedure.
Take care, God Bless-Russ
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