MECC study sets out to prevent chemotherapy-induced alopecia in women of color

06 Oct 2022 --- A clinical experiment at Montefiore Einstein Cancer Center (MECC) is currently underway to determine whether scalp cooling can prevent Black and Latina women with textured hair from chemotherapy-induced alopecia (CIA).

A key element of the study is establishing which women are more likely to lose their hair permanently as a result of CIA.

“For too long, science has failed to identify strategies for preventing hair loss in a diverse patient population despite the psychological distress we know hair loss can cause,” says Beth N. McLellan, M.D. director of supportive oncodermatology at Montefiore Einstein Cancer Center and chief of the division of dermatology at Montefiore Health System.

“Our goal is to predict who is at high risk for persistent CIA and to see if we can modify existing scalp cooling techniques for Black and Latina women with ‘natural’ hair.”

“We’re not only addressing a top quality of life concern,” she continues, “but also ensuring we are doing everything possible so that worry over hair loss won't cause women to avoid what might be their most effective cancer treatment.”

“Science has failed to identify strategies for preventing hair loss in a diverse patient population,” McLellan says.This experiment is being funded by Pfizer/Skin of Color Society and the American Academy of Dermatology, with Paxman chipping in with some additional costs of equipment.

Keeping your cool
CIA is one of the most prevalent and severe side effects of chemotherapy, affecting approximately 65% of those who receive it. Chemotherapy targets rapidly dividing cells, making it effective at tackling cancer cells, but also causing it to affect hair follicles in the skin.

Cold caps, which are tight-fitting helmet-like headwear filled with a cold gel or liquid, are commonly used in scalp-cooling systems. The caps reduce blood flow to the scalp, preventing chemotherapy chemicals from accessing and killing hair follicles and causing cells to divide more slowly.

Cold caps work best when the cap is close to the scalp, which might be harder to achieve with thick or tightly curled hair as opposed to straight hair.

“We have a lot to learn to identify who is likely to permanently lose their hair due to CIA,” says Dr. McLellan, who is also an associate professor of medicine at Einstein. 

“We look at gene expression and molecular markers to distinguish who is at risk for cancer recurrence and to tailor cancer treatments, why can’t we do the same for hair?”

Taxol or Taxotere for growth
MECC’s study will include 30 women who are receiving taxane-based chemotherapy. Taxanes are a type of medicine that is frequently used as “first-line” therapy for breast, lung, and gynecologic cancers.

In comparison to other chemotherapies, taxanes are eight times more likely to cause chronic, subpar hair growth six months following therapy. Participants can choose between receiving Paclitaxel (Taxol) or Docetaxel (Taxotere) taxanes and will be put into one of two separate study arms.

After their hair has been deep-conditioned and styled into loose braids or twists, participants will enter into a round of scalp cooling.

In a separate control group, some participants will not receive any hair styling or scalp cooling to evaluate the efficacy of the method in patients with textured hair.

Edited By Mieke Meintjes