1018 - Quantification and Qualification of Breast Cancer Patient Navigation from the Navigator-Assisted Hypofractionation (NAVAH) Phase I Clinical Trial
Presenter(s)
S. McClelland III1, U. J. Burnette2, T. K. Smith2, L. Onyewadume3, C. Cheatham4, C. Speers5, and J. Lyons6; 1University of Oklahoma Stephenson Cancer Center, oklahoma, OK, 2Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, 3Duke University Department of Radiation Oncology, Durham, NC, 4University Hospitals, Cleveland, OH, 5University of Alabama-Birmingham, Department of Radiation Oncology,, Birmingham, AL, 615University Hospitals Seidman Cancer Center / Case Western Reserve University / University Hospitals of Cleveland, Cleveland, OH
Purpose/Objective(s): Since its creation in 1990 at Harlem Hospital by surgical oncologist Dr. Harold Freeman, patient navigation has become increasingly adopted as a key component of optimal cancer care. However, in the 35 years since, patient navigation has yet to be formally implemented for Black patients receiving radiation therapy (RT) as part of cancer care. The Navigator-Assisted Hypofractionation (NAVAH) program is the first to formally assess the impact of patient navigation on RT in Black breast cancer patients, via an ongoing Phase I trial. We present early quantification of navigation as performed in this trial.
Materials/Methods: NAVAH is a prospective single-arm Phase I pilot study, where patients of Black race age 18+ with pathologically confirmed breast cancer following resection are eligible. Patients seen by Radiation Oncology and consented to receive RT are approached for trial participation. Participants are assigned a patient navigator to aid them throughout the course of RT and post-RT care and provided travel vouchers to offset RT transportation cost. The primary trial endpoint is RT completion rate following initiation of patient navigation. Interactions between enrolled patients and their assigned patient navigator were assessed to quantify frequency of interaction, duration of interaction, and common topics pertinent to patient concerns.
Results: From 3/27/24-11/21/24, the first 39 patients enrolled were evaluated for navigator interactions; no patient had received navigation prior to enrolling on trial. Navigator interaction with patients occurred 0.5 times per week, with mean duration of 18.7 minutes (median=20 minutes; range=10-40 minutes). The topic of financial assistance was a primary reason for interaction in 11 patients (28%), patient-initiated in each instance. A positive bond association was reported for 15 patients (38%). 97% of patients expressed satisfaction with navigation services with one patient declining further navigation due to following dissatisfaction with navigation services. Positive bond associations most commonly involved the topics of survivorship, support, kindness, racial identity, and spiritual faith.
Conclusion: Thus far, patient navigation on the ongoing NAVAH Phase I clinical trial has involved navigator interaction with patients on average of two times per month, with each interaction lasting nearly 20 minutes. More than one-third of interactions involved discussion of financial assistance, and more than 30% of patients reported a positive bond association with the navigator. The majority of patients (97%) have expressed satisfaction with navigation services. These findings provide a framework to quantify present and future patient navigation programs for breast cancer patients receiving adjuvant RT (clinicaltrials.gov, NCT05978232).