Simple blood test could help spot signs of skin cancer returning

Researchers are trialling a blood test that could help skin cancer patients avoid unnecessary treatment.

Karen Dickinson, a mum-of-two, was diagnosed with skin cancer after a chance encounter.

She is now part of the DETECTION-2 trial. It will help confirm if a simple blood test can spot signs of melanoma returning faster than regular scans.

The trial is funded by Cancer Research UK. It is being run by the Southampton Clinical Trials Unit (SCTU).

The study is open at eight hospitals across the UK, including University Hospital Southampton.

Most serious form of skin cancer

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

The 57-year-old IT manager saw her GP the next day. Karen was referred for tests, which confirmed she had melanoma – the most serious form of skin cancer.

Unfortunately, she was also told that the melanoma – which affects 3,100 people in the South East every year - had spread to her lymph nodes.

Karen had surgery to remove the mole, a wider area of skin and the affected lymph nodes. She was unable to work for a month.

“It was such a shock”, Karen said. “I had noticed the mole and 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 everything happened so fast. They had removed it and diagnosed me with melanoma skin cancer all within a few weeks.”

Melanoma rates have increased by almost a third over the past decade, analysis by Cancer Research UK shows. It is now the fifth most common cancer in the UK.

Karen continued: “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. 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.”

Preventing unnecessary treatment

Karen is one of 50 people taking part in DETECTION-2. The trial aims to prevent people from having unnecessary treatment if their cancer is unlikely to return.

Most people who are diagnosed with melanoma at an early stage have their cancer successfully removed with surgery. However, in a small number of cases, the cancer will come back.

The NHS currently offers patients 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. This would ensure 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. Their presence highlights that the melanoma has returned.

A more targeted approach

The trial is led by teams of researchers from the SCTU, The University of Manchester and The Christie NHS Foundation Trust.

Professor Paul Lorigan, a Consultant Medical Oncologist at The Christie, is leading on the trial. He said:

“While immunotherapy or targeted therapy after surgery can help to prevent cancer returning, most patients do not need this. Giving this treatment to everyone means that many patients may unnecessarily receive additional treatment. This can have serious and long-term side effects.

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

‘Hugely beneficial’

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

Sarah Bibby, Senior Trial Manager at the SCTU, 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. If at any point a test indicates the return of the melanoma, the patient will then go on to have drug treatment.”

All participants will continue to have regular scans and skin checks. They 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. I feel reassured 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. 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 the first phase of the trial is successful, it will be expanded to more hospital sites.