Last month, the biotech company Immunocore announced results from its phase 3 clinical trial investigating the efficacy of Tebentafusp (a new anti-tumour immunotherapy), in the treatment of patients with metastatic melanoma. If it is given regulatory approval, it is likely that the drug will enter wider clinical use next year. If it does, it will give those living with uveal melanoma (UM), a rare cancer, a new treatment option and would be the first new therapy to improve the overall survival of this group of patients in over 40 years. Susan was one of the first patients to receive the drug when it was in its early stages of development.
Susan’s Clinical Trial Experience
In 2008, what appeared to be a small spot on the top of my head turned out to be melanoma. After surgery at the John Radcliffe Hospital in Oxford to remove the tumour there was no sign of recurrence, until 2012 when the melanoma had apparently spread to my lungs. It was at then that I was invited to enrol on a clinical study at Oxford’s Early Phase Clinical Trials Unit (EPCTU).
I met Professor Middleton, head of the trials unit, in 2012 following the appearance of cancer metastases in my lungs when he informed me of a new clinical trial he was leading, investigating a drug called IMCgp100, now known as Tebentafusp. At the time, there was no way to know if the drug would help in any way. Early-stage clinical trials for a new drug are not tried and tested, the side effects are not always clear and the outcomes not always sure.
For me, in the first 30 days of the trial I experienced rashes, headaches and lethargy. Common for many undergoing cancer treatments, but unpleasant none-the-less. Throughout the whole time I was on the trial the doctors and nurses were completely honest with me. There were no promises. They were on a learning curve themselves and if they didn’t know the answer to a question, they said so.
However, gradually these side effects subsided, and it became clear on my scans that the tumour had begun to shrink. Later on, it had stopped shrinking, but had not grown either. After 14 drug cycles on the trial, I attended my last scan. The tumour in my lung had shrunk to an operable size, and after another operation in 2015, the cancer was removed.
I cannot tell you how wonderful it felt when I was told that there was no sign of any tumour in the left lung and that the right one was continuing its downward trend. All of this was because of an experimental drug in an ever-evolving trial that I was part of.
At the time it didn’t occur to me that my experience was laying the ground work for the introduction of a new drug into common use.
From being told I had 18 months left to live in 2012, to being cancer free in 2015, I think my case exemplifies why clinical trials are important. It was fortunate that I qualified to be part of a first stage clinical trial in Oxford, and one that went on to help me. But even more, it is fantastic to hear that the same drug I was treated with has now gone on to complete a phase 3 trial, and have the potential to give people like me a new lease on life.
Whist clinical trial drugs are experimental until rigorously tested, the knowledge and resources of the staff at the University of Oxford is what contributed to the early identification of Tebentafusp as a potential therapy, so that it may go on to be translated into the clinic to help me and other melanoma patients.
Sometimes in life, something is so important that you have to make a decision without any knowledge of where it will lead you.
I made that decision and underwent a clinical trial that was administered under rigorously strict guidelines, with the patient’s safety as paramount
I don’t know whether the cancer will return, as I believe melanoma is a tricky devil, but I feel as if I have been given a second chance and my remission wouldn’t have been possible without the researchers and staff at Oxford involved in the development of new drugs.
About the clinical trial
Tebentafusp was tested in a phase 1 and 2 clinical trial by researchers at the University of Oxford and Immunocore, hosted at the EPCTU. The success of those trials has allowed the drug to be tested in stage 3 trials which were recently reported on by Immunocore.
The detailed results of the phase 3 trial will be submitted for publication in a peer-reviewed journal later next year. All the information about the drug will be submitted to the regulator, the MHRA, for their assessment after which it is hoped that the drug will enter the clinic.
The phase 1 and 2 trials were led by Prof Mark Middleton at the Department of Oncology.