Chemotherapy drug concentrations in hair follicles: a potential biomarker to monitor the effectiveness of scalp cooling for chemotherapy-induced alopecia

Excerpt

Chemotherapy-induced alopecia (CIA) is commonly described as one of the most distressing adverse events of breast cancer treatment, with patients experiencing negative body image and poor self-esteem [1]. Breast cancer patients have described CIA as being more devastating than losing a breast, as hair loss often signifies as a visible sign of cancer as well as a loss of femininity [2]. Women even refuse chemotherapy due to this fear [1]. Two trials were recently published and had reported the effectiveness of scalp cooling to prevent CIA. In one study (n = 182), scalp cooling prevented hair loss in 50% of patients randomized to the scalp cooling, compared to those in the control arm in which all patients experienced hair loss [3]. Another multicenter prospective cohort study, which enrolled 106 women treated taxane-based chemotherapy, reported that scalp cooling prevented hair loss in 66.4% of all participated patients, whereas all patients without receiving scalp cooling experienced hair loss [4]. These data have also led to FDA clearance to market for two scalp cooling systems (Dignicap® and Paxman®) that reduce hair loss in breast cancer patients undergoing anthracycline- or taxane-based chemotherapy. …