From the moment chemotherapy begins, says breast cancer survivor Nicola La Porte, there is only one thing patients want to know: “Is it working?”
It usually takes weeks until a scan shows if a cancer is responding. La Porte, 34, had to wait for two months after her treatment began in 2019 to be told that the tumour in her breast had disappeared. “It made continuing 1,000 times easier,” she said.
Despite losing her hair and coping with constant nausea and fatigue while looking after her daughter Juliet, aged two at the time, La Porte said she felt able to survive the rest of her five rounds of chemotherapy, surgery and radiotherapy.
A technique developed by Cambridge University researchers promises to give patients that same confidence within days. After one dose of chemotherapy, scientists are able to detect chemical changes that indicate if a tumour is responding to treatment.
Their findings, published in the Cancer Research journal, suggest that giving a patient an injection of a special solution, followed by an MRI scan, can indicate within a week if treatment is working. This will also allow doctors to change treatments if the chemotherapy is failing.
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The study leader, Professor Ferdia Gallagher, a radiologist at Addenbrooke’s hospital in Cambridge, said: “Usually we look at the size of a tumour to see if a treatment is working. But it can take months to see that change.”
The new technique, carried out initially on seven breast cancer patients — including La Porte, who volunteered for the trial — instead assesses a tumour’s metabolism. All cancers absorb sugar at high rates. Once they have absorbed that sugar they produce lactate, a waste product. The researchers found that when patients respond well to chemotherapy, lactate production rises. This happens much sooner than changes in the tumour size.
The researchers found that La Porte and two other patients who had a high lactate output in their first days of treatment would go on to see their tumours disappear a few weeks later. Those who had lower lactate outputs did not see such a strong response.
Because it was a trial, La Porte was not made aware of the results. But, if more trials work as well, future patients could be given their outlook within days.
The potential stretches far beyond breast cancer. The technique could be used to track treatment responses for cancers of the prostate, bowel, brain and lungs. It also has the potential to be used for immunotherapies and radiotherapy.
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Michelle Mitchell, chief executive of Cancer Research UK, which funded the research alongside the Mark Foundation for Cancer Research, said: “We’re looking forward to seeing how the research develops.”
