Personalising treatment for early-stage Hodgkin lymphoma
Hodgkin lymphoma is one of the most common cancers seen in young adults. In its early stages, Hodgkin lymphoma is usually treated with chemotherapy followed by radiotherapy. Many people are cured, but long-term survival may be threatened by complications resulting from this treatment, such as infertility, second cancers and heart disease.
Leaving out radiotherapy would reduce these complications, and the Bloodwise-funded RAPID trial showed that if people have a specialist scan called ‘PET’ after their chemotherapy and there are no signs of the cancer, radiotherapy can indeed be left out. But unfortunately, the trial showed that Hodgkin lymphoma is more likely to come back in people who did not have the radiotherapy.
Dr Kim Linton and her team at the University of Manchester want to personalise treatment for Hodgkin lymphoma even further, finding the delicate balance between preventing the cancer from returning, and reducing the harsh long-term side effects.
Researchers are looking at samples from people that were taken at diagnosis before taking part in the RAPID trial; so before any treatment was given. Dr Linton will look at the activity of genes which are known to drive Hodgkin lymphoma. These unique gene ‘fingerprints’ could help researchers predict which patients might relapse in the future, and who will be cured.
Once this work is done, researchers hope to combine information from the gene fingerprints and PET scans to develop a simple test that will more accurately identify people who will relapse or be cured. Test results will help to personalise treatment - those with the highest risk of relapse will get radiotherapy, and those with a high chance of cure with chemotherapy alone will avoid the potentially life-changing effects of radiotherapy.