Hope for chemotherapy-induced hair loss
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Hope for chemotherapy-induced hair loss

From the patient’s perspective, hair loss (alopecia) ranks second only to nausea as a distressing side effect of chemotherapy. Research presented at the 91st Annual Meeting of the American Association for Cancer Research (AACR) demonstrates promising results from a new synthetic compound in preventing hair loss caused by a common chemotherapy drug.

Like cancer cells, the epithelial cells surrounding hair follicles divide rapidly. Therefore, traditional anticancer agents that target rapidly dividing malignant cells also cause hair loss. Stephen T. Davis, PhD and researchers at Glaxo Wellcome, Inc. in Research Triangle Park, North Carolina, focused on developing a compound to selectively inhibit activity of an enzyme involved in cell division called cyclin-dependent kinase 2 (CDK2). They now have evidence that CDK2 prevents chemotherapy-induced alopecia without reducing the anticancer effect of chemotherapy drugs.

In in vitro studies on human cells, the synthetic compound GW8510 demonstrated encouraging initial results. When Davis put the gel on rats who had been given the chemotherapy drug etoposide, the gel GW8510 was "100% effective in preventing hair loss in about half of the rats and partially effective in the remaining 40%." Etoposide is used to treat malignancies such as cancers of the testes, lung and bladder, as well as lymphoma, acute myelocytic leukemia and Ewing’s sarcoma. He says that the compound offered "stunning protection." Davis, presented the study at the meeting of the American Association for Cancer Research.

“There is a tremendous unmet need to prevent chemotherapy-induced hair loss and eliminate this additional stress factor among patients already emotionally devastated by a cancer diagnosis, “ said Davis. GW8510 has also shown efficacy in protecting against alopecia caused by cyclophosphamide (Cytoxan) and doxorubicin (Adriamycin), agents used in treatment of advanced metastatic breast cancer and other malignancies. Researchers are targeting this approach for a Phase I clinical trial in the advanced breast cancer setting.

Another cancer researcher, William N. Hait, MD, PhD, director of the Cancer Institute of New Jersey, says that it is only recently that cancer research has turned to quality of life issues that affect cancer patients. At one time, very few cancer patients survived, but now about half of the one million Americans who will be diagnosed this year with cancer will survive the disease. But researchers are now faced with issues about the quality of that survival, as well as the pain and suffering patients endure during active treatment. Improved pain medication has been helpful and new drugs are effectively counteracting the nausea caused by chemotherapy, but so far efforts to prevent hair loss have been ineffective.

One early approach to protecting against the hair loss, also called alopecia, was the use of "ice caps. Patients would wear these caps with the hope that they would freeze the scalp and thus protect the hair from the effects of chemotherapy," Hait said. Ice caps were extremely painful and also offered only selective protection because "only some areas of the scalp would actually be frozen."

Hait says the results of Davis' study are very encouraging but that the cancer drug used in the study, etoposide, doesn't cause the severe hair loss seen with some other drugs. He says, for instance, that women taking Taxol for treatment of breast cancer usually lose all body hair, "even eyebrows, a condition called alopecia totalis." Etoposide is used for treatment of cancers of the bladder, testicles, and lung. Hait says that it would be interesting to test the drug's effectiveness against Taxol. Davis counters by saying that "rats given Taxol don't lose their hair, but we did test the compound on rats treated with [two other cancer drugs], which do cause alopecia totalis." He says the compound was just as efficacious in those rats as well.

Here's how the gel works. Chemotherapy attempts to kill cancer cells but because the cells of healthy growing hair behave in much the same way as cancer cells, they get killed too. By spreading the gel on the scalp, the compound can offer short-term protection to the hair follicles while not interfering with the cancer-killing potential of the chemotherapy drugs, says Davis. He says that the gel is applied before chemotherapy is given and then washed off after chemotherapy. "The duration of action of the compound is 24 hours," he says. Because the gel is on the scalp for such a brief period, "there are no observable cosmetic affects on the hair. There is neither less hair, nor more hair," he says.

He says that the rat studies of the compound found that it had no harmful effect on the skin and the company is now proceeding with plans for a human study.

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