31st October 2022

For many women of colour hair can represent an important link to their history, culture and identity.
 
“For too long, science has failed to identify strategies for preventing hair loss in a diverse patient population despite the psychologic distress we know hair loss can cause,” said Beth N. McLellan, M.D. director, Supportive Oncodermatology at Montefiore Einstein Cancer Center, 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, 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.”

Thirty women undergoing taxane-based chemotherapy will be enrolled for the MECC study. Taxanes are a class of drugs that are often used as a “first-line” therapy for breast, lung, and gynaecologic cancers, which are among the most prevalent cancers in the Bronx, where MECC is based. Taxanes are also associated with an eight-times higher risk of persistent, suboptimal hair growth six months after treatment compared to other chemotherapies. The commonly used taxanes are the drugs Paclitaxel (Taxol) and Docetaxel (Taxotere).
 
Participants will be assigned to one of two different study arms based on their preference. The participants who select the treatment arm will undergo scalp cooling after their hair is prepared with a deep conditioner and put into loose braids or twists. There will also be a control group in which the participants will receive no hair preparation or scalp cooling. The goal is to determine if using this specialised hair preparation technique, intended to reduce the volume of hair, improves scalp cooling efficacy and CIA prevention in patients with textured hair. The investigators have partnered with a local hairstylist to perform onsite hair preparation and to assist women with styling.
 
To investigate cellular and genetic determinants of CIA, investigators will perform genomic sequencing on samples of plucked hairs, rather than traditionally used, more invasive skin biopsies, to identify possible biomarkers for CIA.
 
“We have a lot to learn to identify who is likely to permanently lose their hair due to CIA,” said 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?”
 
Paxman is supporting the trial by providing the cooling caps and scalp cooling machines, and the trial is being funded by grants from Pfizer/Skin of Color Society and the American Academy of Dermatology.