High-tech scans may spare cancer patients chemo side effects

High-tech scans may help predict the outcome of treatment of patients suffering from cancer of the lymphatic system, sparing them the serious side effects of chemotherapy, according to a new study.
Scientists including researchers from University of Southampton in the UK used positron emission tomography (PET) to scan more than 1,200 patients with advanced Hodgkin lymphoma after they had been given two cycles of standard chemotherapy.
Those who had a clear PET scan were split into two groups - one group continued with chemotherapy including the drug bleomycin and the other had chemotherapy without the drug.
Researchers found that patients who stopped having bleomycin had the same survival rates as those who continued it. But importantly, they were spared side effects.

Patients on the trial who did not have a clear PET scan after two rounds of chemotherapy, suggesting they had a more resistant form of the disease, were given more intense chemotherapy treatment.
Bleomycin has been an important drug to treat Hodgkin lymphoma for 30 years, but it has a potential risk of severe effects on the lungs, with the risk of scarring, even years later, that can lead to serious breathing problems, researchers said.

Due to these risks, they wanted to explore the potential of adapting treatment by stopping bleomycin for patients with a good outlook and escalating treatment only for those at highest risk of the treatment not working.

"Personalising treatment based on how well it works is a major development for patients with Hodgkin lymphoma," said Peter Johnson from University of Southampton.
"Knowing which patients have a more difficult to treat form of the disease means we can select those who need stronger chemotherapy, while sparing everyone else the severe side effects such as infertility," said Johnson.
"This approach, along with a reduction in the need for radiotherapy, should substantially reduce damage to healthy tissues and the risk of second cancers caused by treatments," he added.
The findings were published in the New England Journal of Medicine.