Rebecca Smith, 53, from Solihull, was diagnosed with eye cancer in early 2020, just before the pandemic. Within weeks, she underwent surgery to remove her eye and adapted quickly to life with an artificial eye. For several years, she remained cancer-free – until the disease spread to her liver.
“I started immunotherapy last year, and while it offered hope, the side effects were brutal,” Rebecca explains. “I developed colitis, meningitis, and severe arthritis that attacked 90% of my joints. I couldn’t climb stairs, get dressed, or even get out of bed without help. It was devastating.”
These side effects forced Rebecca to take a year off work. “I love my job, but I simply couldn’t manage. Every cycle of treatment left me in hospital with side effects. It was a vicious circle.”
Standard steroid therapy offered little relief and clashed with her ongoing immunotherapy. That’s when her consultant suggested the REACT trial.
“I jumped at the chance. I thought, if it doesn’t work, at least I’ve tried – and maybe I’ll help others,” she says.
Rebecca was randomly assigned to receive adalimumab injections every two weeks. The impact was life-changing: “It’s been a godsend. My pain has eased, I can walk, I’ve returned to work, I can even wear heels again! My quality of life is back to what it was before.”
She still experiences mild aches before her next dose, but the improvement has been dramatic. “I’ve gone from being housebound to going on holiday and making memories with my family. Trials like this give people hope – and that’s priceless.”
Rebecca shares her journey on Instagram (@one_eye_survivor_living_life) to inspire others: “Don’t lose hope. Cancer and its side effects aren’t the end of the world. If you get the chance to join a trial, take it. It might change your life – it’s certainly changed mine.”
To compare the safety and effectiveness of these treatment strategies, the trial aims to recruit 70 ICI-induced arthritis patients across multiple centres in the UK. Participants will either receive current standard of care (initial steroid treatment in the form of prednisolone) or the anti-TNF drug adalimumab.
Treatments will be gradually reduced once the arthritis is controlled, or further treatment given if needed. The research team will compare the proportion of patients in each treatment group who have no arthritis and no steroid use 6 months after the start of treatment.
Researchers will also compare how fast the arthritis is controlled, and will continue to follow patients until 1 year to compare arthritis activity, quality of life, ability to function, total amount of immunosuppressive drugs received over time, number of ICI doses missed, new immune-related side effects, cancer outcomes and survival.
The clinical trial has received funding of more than £1 million from the National Institute for Health and Care Research (NIHR), supported by the NIHR UK Musculoskeletal Translational Research Collaboration and the NIHR/Wellcome Trust Birmingham Clinical Research Facility. The trial will run until August 2028 at the University’s Birmingham Cancer Research UK Clinical Trials Unit (CRCTU), which is globally renowned for its academic excellence and enables innovative research with the potential to change lives, in both cancer and non-cancer fields like inflammatory diseases.
