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Protein injection could prevent hair loss during chemotherapy

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Mice injected with a hair-promoting protein did not lose their hair during chemotherapy. The finding raises the hope that people undergoing cancer treatment can one day avoid this distressing side effect.

Hair loss is one of the most feared side effects of chemotherapy. One study of women with breast cancer found that around 8 per cent had considered refusing treatment to save their locks.

There are few options for people receiving treatment. Scalp-cooling caps freeze and constrict blood vessels to stop chemo drugs from flowing into hair follicles. But they are expensive, work for only 50 per cent of people, extend treatment by two hours and cause discomfort and headaches.

Other people have experimented with using the hair loss treatment minoxidil during chemo, but a randomised controlled trial found no benefit.

Part of the problem is our limited understanding of how chemotherapy damages hair follicles, says Sung-Jan Lin at National Taiwan University.

To address this, his team looked at the role of a protein called p53. This protein is activated during chemo and helps to suppress tumour growth, but may also suppress hair growth, since hair cells rapidly divide like tumour cells. A previous study found that mice missing the p53 protein did not shed their fur during chemo.

Hair-promoting protein
Studying p53, Lin and his colleagues have found that it blocks the activity of a hair-promoting protein called WNT3a. This gave them an idea: if you inject WNT3a directly into the scalp when administering chemo, will it stop hair loss?

To test this, they dosed mice with a common chemotherapy agent. Straight afterwards, they injected WNT3a-soaked beads under the surface of their skin. The microscopic beads – which were coloured blue – helped to keep the protein in a small area so the team could study its effects.

Sure enough, areas injected with the WNT3a-soaked beads were still coated with thick fur five days after chemo. In contrast, areas injected with untreated beads went bald.

When the researchers examined patches of skin under the microscope, they found the protein treatment doubled the number of stem cells in the base of the hair follicles within the first day of injection, allowing more hairs to sprout.
The team is now working on adapting the treatment for use in people. It would not be practical or safe to inject the hair-promoting protein into the scalp in bead form, says Lin. “We might need to inject it into the scalp using arrays of fine needles so that many of the hair follicles can be covered,” he says. His team is also testing compounds they have designed for activating WNT3a that could be spread over the scalp in cream or gel form.

Richard de Boer, a medical oncologist at Epworth Centre in Melbourne, Australia, says the treatment could be a big help. While scalp cooling has led to many success stories, it doesn’t work well for some types of chemotherapy, he says. “New hair-saving options that work with all chemotherapy regimens would be very welcome.”

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Journal reference: Cancer Research, DOI: 10.1158/0008-5472.CAN-17-0667

Source: https://www.newscientist.com/article/2149608-protein-injection-could-prevent-hair-loss-during-chemotherapy/

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Early-stage breast cancer patients may not require chemotherapy, says new study

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There’s good news for cancer patients. A new study done by Montefiore Medical Center in New York says that most women with early-stage breast cancer can safely skip chemotherapy without hurting their chances of beating the disease.

The landmark study is the largest ever done of breast cancer treatment and used genetic testing to gauge each patient’s risk. The results are expected to spare patients the ordeal and expense of the chemo drugs. “The impact is tremendous. Most women in this situation don’t need treatment beyond surgery and hormone therapy,” said the study leader Dr Joseph Sparano of Montefiore Medical Center in New York.

The study was funded by the National Cancer Institute, some foundations and proceeds from the US breast cancer postage stamp. Results were discussed at an American Society of Clinical Oncology conference in Chicago and published by the New England Journal of Medicine.

Moving away from chemo

Cancer care has been evolving away from chemotherapy — older drugs with harsh side effects — in favour of gene-targeting therapies, hormone blockers and immune system treatments. When chemo is used now, it’s sometimes for shorter periods or lower doses than it once was.

For example, another study at the conference found that Merck’s immunotherapy drug Keytruda worked better than chemo as initial treatment for most people with the most common type of lung cancer, and with far fewer side effects. The breast cancer study focused on cases where chemo’s value increasingly is in doubt: women with early-stage disease that has not spread to lymph nodes, is hormone-positive (meaning its growth is fuelled by estrogen or progesterone) and is not the type that the drug Herceptin targets.

The usual treatment is surgery followed by years of a hormone-blocking drug. But many women also are urged to have chemo to help kill stray cancer cells. Doctors know that most don’t need it, but evidence is thin on who can forego it.

What the study found

About 17% of women had high-risk scores and were advised to have chemo, while 16% women with low-risk scores skipped chemo, based on earlier results from this study. The new results are on the 67% of women at intermediate risk. All had surgery and hormone therapy, and half also got chemo. After nine years, 94% of both groups were still alive, and about 84% were alive without signs of cancer, so adding chemo made no difference.

Some of the women aged 50 or younger did benefit from chemo. Slightly fewer cases of cancer spreading far beyond the breast occurred among some of them given chemo, depending on their risk scores on the gene test.

Women should get gene testing to guide their care, said Dr Richard Schilsky, chief medical officer of the oncology society. Testing solved a big problem of figuring out who needs chemo, said Dr Harold Burstein of the Dana-Farber Cancer Institute in Boston. “Many women think ‘If I don’t get chemotherapy, I’m going to die, and if I get chemo, I’m going to be cured’, but the results show there’s a sliding scale of benefit and sometimes none,” he said.

Source: https://www.hindustantimes.com/health/good-news-for-breast-cancer-patients-many-may-not-require-chemotherapy/story-Zz20ypuV5WlaqIzEicpnUP.html

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