Trial begins of a blood test to spot the signs of cancer returning

A mum diagnosed with skin cancer after a chance encounter is taking part in a new clinical trial to see whether a pioneering blood test could spot signs of melanoma returning faster than regular scans.

The Ìì·¢ÓéÀÖÆåÅÆ_Ìì·¢ÓéÀÖAPP-¹ÙÍø|ÏÂÔØ Clinical Trials Unit is running a Cancer Research UK-funded trial to discover if a simple blood test can tell doctors at a very early stage if the melanoma is back, even if a scan looks normal.

The hope is that it could mean quicker diagnosis for people at risk of a relapse and prevent people whose melanoma is not coming back from having unnecessary treatment.

The DETECTION-2 trial is funded by Cancer Research UK and is being led by researchers at the University of Manchester, Cancer Research UK National Biomarker Centre and The Christie NHS Foundation Trust and the Cancer Research UK Ìì·¢ÓéÀÖÆåÅÆ_Ìì·¢ÓéÀÖAPP-¹ÙÍø|ÏÂÔØ Clinical Trials Unit.

Among the first patients taking part is mum-of-two, Karen Dickinson, who says she hopes being on the trial will have both mental and physical benefits for her.

A chance diagnosis

Karen, 57, was at a routine appointment for her arthritic knee when her osteopath pointed out an irregular looking mole on her lower back.

The next day, the IT manager went to see her GP who referred her for tests which revealed that Karen had melanoma ¨C the most serious form of skin cancer. Unfortunately, she was also told that the melanoma had spread to her lymph nodes.

Karen had surgery to remove the mole including a wider area of skin as well as the affected lymph nodes and she was unable to work for a month.

She said: ¡°It was such a shock. I had noticed the mole one day getting out of the shower and wondered if it was slightly darker. I thought it may have been due to the fact we¡¯d been on holiday, even though it had been covered up. So, I had decided to keep an eye on it, but when my osteopath pointed it out and said I should get it checked sooner rather than later, I went straight to my GP.

¡°Then it all just happened so fast. They had removed it and diagnosed me with melanoma skin cancer all within a few weeks.

¡°I had no idea how serious melanoma was, and you do worry that you could die. Telling my husband Stephen and my two girls Chelsea and Alex was hard. Having cancer has changed my outlook on life.

¡°You do worry it might come back, but it absolutely doesn¡¯t define who I am. It¡¯s made me prioritise my time and not take my health for granted anymore. My time is precious, and I value what is most important to me more than ever.¡±

Now, Karen has signed up to the DETECTION-2 clinical trial which will be recruiting 50 patients at 12 hospitals across the UK.

Video credit - Cancer Research UK

Spotting the signs of cancer returning

For most people who are diagnosed with melanoma at an early stage, the cancer will be successfully removed by surgery. But in a small percentage of patients the cancer will come back.

On the NHS, patients are currently offered a one-year preventative drug treatment aimed at reducing the risk of recurrence. But with this new blood test developed by scientists at the Cancer Research UK National Biomarker Centre, it could be possible to identify patients most at risk so that further treatment is only given to those who really need it.

The test can spot small fragments of DNA shed by cancer cells - known as circulating tumour DNA or ctDNA, highlighting that the melanoma has returned.

¡°While immunotherapy or targeted therapy after surgery can help to prevent cancer returning, the majority of patients do not need this,¡± says consultant medical oncologist at The Christie, Professor Paul Lorigan, who is leading the trial. ¡°Giving this treatment to everyone means that many patients may unnecessarily receive additional treatment, which can have serious and long-term side effects.

¡°Ideally, only patients likely to have the melanoma return would receive the additional treatment and we therefore want to see if we can use a simple blood test to spot those patients who are most at risk.¡±

Patients who decide to take part will be randomly assigned to one of two groups, which will be compared at the end of the study.

Sarah Bibby, senior trial manager at the Ìì·¢ÓéÀÖÆåÅÆ_Ìì·¢ÓéÀÖAPP-¹ÙÍø|ÏÂÔØ Clinical Trials Unit, said: ¡°Half of the patients will receive the standard NHS care consisting of one year of preventative drug treatment after surgery. The other half will have regular ctDNA blood tests following surgery instead, and if at any point a test indicates the return of the melanoma, the patient will then go on to have drug treatment.¡±

Senior Lecturer in medical oncology at The University of Manchester and Principal Investigator on the trial, Dr Rebecca Lee added: ¡°If ctDNA is detected, then we can fast-track patients on to treatment and this would mean that only those patients who really need drug treatment receive it.¡±

All participants will continue to have regular scans and skin checks and will be followed up for five years, including Karen whose first blood test has shown no signs of melanoma.

Karen added: ¡°The benefit for me of this brand-new trial is that I don¡¯t need to go on medication, that could make feel very ill, if I don¡¯t need it. Also, I have that reassurance that alongside the regular scans and checks, I will have these fantastic blood tests every three months that show up signs of the cancer coming back up to 12-months earlier than a scan. So, for me it¡¯s hugely beneficial both mentally and physically.¡±

The research team is working closely with the charity Melanoma Focus and its patient groups. If this first phase of the trial proves to be successful, it will be expanded to more hospital sites and more patients.

Analysis by Cancer Research UK showed that rates of melanoma have increased by almost a third over the past decade with around 16,000 people diagnosed with melanoma every year in the UK.*

With melanoma cases in the UK on the rise, this clinical trial has come at a crucial time according to Cancer Research UK¡¯s Executive Director of Research and Innovation Dr Iain Foulkes.

He said: ¡°Cancer Research UK?is dedicated to discovery science while ensuring our findings in the laboratory have patient benefit. This project is an important step towards ensuring that our understanding of cancer can provide more personalised treatment for people diagnosed with melanoma, whilst sustaining their quality of life."

Melanoma Focus CEO Susanna Daniels added: ¡°It¡¯s hoped that by using these ctDNA blood tests, doctors will be able to identify very early on which patients have a high chance of the melanoma returning and treat those patients accordingly. Doctors will also be able to provide reassurance to those patients that do not have ctDNA in their blood that their melanoma is not returning, and therefore avoid unnecessary treatment and potential side effects for many patients.¡±