Cardiff University Recruits First Patient for Groundbreaking SCC-AFTER Trial

The Centre for Trials Research at Cardiff University is thrilled to announce the recruitment of the first patient in the SCC-AFTER study.

The study is aimed at improving outcomes for patients with cutaneous squamous cell carcinoma (cSCC), a prevalent form of non-melanoma skin cancer. This trial, funded by the National Institute for Health and Care Research (NIHR), is the first of its kind globally and seeks to explore the benefits of radiotherapy in preventing cancer recurrence.

Standard care for cSCC is for the cancer to be excised (surgically removed). Despite there being no cancerous cells detected at the outer edge, there is a risk of cancer returning in the same area, which is known as loco-regional recurrence. Some features of the cancer make this slightly more likely to happen and these are known as high-risk but completely excised cSCC. These patients will have close clinical follow-up. Patients whose cSCC reappears can experience a big reduction in their quality of life. Across the UK, the standard of care that patients receive differs between clinicians and hospital trusts so some patients may be given radiotherapy but there is no clear evidence of how much benefit this is.

SCC-AFTER will investigate whether administering radiotherapy, in addition to close clinical follow-up, can reduce loco-regional recurrence in patients with high-risk but completely excised cSCC.  This trial will recruit 840 patients across UK NHS sites over the next four years. Each patient will be followed up for a minimum of three years to gather comprehensive data relating to their quality of life and recurrence of symptoms of cSCC.

The study will monitor all patients for cancer recurrence, treatment side effects, and quality of life. SCC-AFTER has been adapted and designed to include patients who are traditionally under-represented in clinical trials, such as older or frailer individuals, those with multiple long-term conditions, immunocompromised patients, and those from socio-economically disadvantaged backgrounds.

The outcomes of the SCC-AFTER study will provide robust and reliable evidence to guide future national treatment recommendations, potentially improving patient outcomes and setting new standards in cSCC care. If radiotherapy proves effective in preventing cSCC recurrence, it could become a recommended routine treatment within the NHS.

The joint Chief Investigators are Prof. Agata Rembielak and Prof. Catherine Harwood who specialise in Clinical Oncology and Dermatology respectively. They are supported by a team of experts from across the UK. The trial is run by the Centre for Trials Research (Cardiff University) with core funding provided by Health Care Research Wales.

“At the time I was approached to take part, I’d had a difficulty year with different health issues and lots of health service involvement, so I felt like I owed it to the NHS to do my bit.  If the trial doesn't benefit me directly, hopefully it will do some good for others in my position.” said the first patient recruited to SCC-AFTER.

"As a skin cancer patient involved in the set-up of this study, I am so pleased it is now open, and the first patient has been recruited. This study is needed in order to prove whether or not certain skin cancer treatments can be of benefit to the patient."  said Patricia Fairbrother, SCC-AFTER Research Partner.

“We hope that this trial will improve the clinical practice in the management of squamous cell carcinoma of the skin (skin SCC) which is already a very common form of skin cancer and is increasing in incidence.  We have identified an unmet need around the use of postoperative radiotherapy to treat patients with 'high-risk' SCCs. Given the large number of patients affected by skin SCC, we hope that the evidence gathered in SCC-AFTER will have an important role in improving outcomes from this common skin cancer.” explained Prof. Agata Rembielak, Consultant Oncologist and Prof. Catherine Harwood, Consultant Dermatologist who are the joint chief investigators for the SCC-AFTER trial.

“We are pleased to see the first patient of many to be recruited to this important clinical trial which has the potential to better inform the optimum approach for patients with this very common cancer across the globe. The Centre for Trial Research prides itself on bringing collaborative individuals and groups together to develop clinically based team science informed by the patient voice and to answer important clinical questions that affect patient care”. said Prof. Richard Adams, Director of Cancer Trials Centre for Trials Research.

Professor Danny McAuley, NIHR Scientific Director for Research Programmes, said: “Helping researchers to discover the best ways to treat some of the biggest killer diseases in the UK, such as cancer, is one of our top priorities. Our funding will help the team working on the SCC-AFTER study to determine whether radiotherapy will be beneficial in stopping cancer returning in cSCC patients.

“If successful, this could help those affected stay in better health for longer and make a real difference to their lives.”

National Institute for Health and Care Research (NIHR) is funded by the UK government through the Department of Health and Social Care.