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Scientists have uncovered a novel method that could potentially prevent chemotherapy-induced hair loss, with the use of an ex vivo organ culture model. These new findings were published in EMBO Molecular Medicine.



Hair loss (also known as alopecia) is often considered to be one of the most psychologically distressing symptoms of chemotherapy, to the point where treatment could be rejected in order to avoid it.1 Taxanes, a class of chemotherapeutic agents commonly used to treat breast cancer, have been increasingly reported to cause permanent alopecia after use. In this new study, researchers have determined specifically how taxanes cause damage to the hair follicle and thus, how such damage, and the psychological stress it induces, could be prevented.2



How do taxanes cause hair loss?



Taxanes work by preventing cancer cells from being able to go through mitosis; hair loss can occur as a result of their use because they also prevent mitosis in normal dividing cells. In a recent press release, Dr Talveen Purba, lead study investigator, stated: "A pivotal part of our study was to first get to grips with how exactly hair follicles responded to taxane chemotherapy, and we found that the specialized dividing cells at the base of the hair follicle that are critical for producing hair itself, and the stem cells from which they arise, are most vulnerable to taxanes.”



Preventing hair loss using existing cancer therapeutics



Now understanding the mechanism behind taxane-induced hair loss, the researchers intended to find a way to prevent damage to the hair follicle, without compromising taxane’s effects on cancer cells. The answer to this came in the form of CDK4/6 inhibitors, another type of chemotherapeutic considered to exert its effects in a more targeted way.



“Although at first this seems counter-intuitive, we found that CDK4/6 inhibitors can be used temporarily to halt cell division without promoting additional toxic effects in the hair follicle. When we bathed organ-cultured human scalp hair follicles in CDK4/6 inhibitors, the hair follicles were much less susceptible to the damaging effects of taxanes.” said Purba.



Next steps



Nevertheless, the authors were careful to acknowledge that further investigation would be required before their findings could be clinically applied, suggesting a move from an ex vivo model to using xenotransplanted human scalp hair follicles.2



Following on from this, Purba stated: “We need time to further develop approaches like this to not only prevent hair loss, but promote hair follicle regeneration in patients who have already lost their hair due to chemotherapy.”



References



McGarvey, E., et al. (2008) Psychological sequelae and alopecia among women with cancer. Cancer Practice. DOI: https://doi.org/10.1111/j.1523-5394.2001.96007.pp.x



Purba, T.S., et al. (2019) CDK4/6 inhibition mitigates stem cell damage in a novel model for taxane‐induced alopecia. EMBO Molecular Medicine. DOI: https://doi.org/10.15252/emmm.201911031

