Chemotherapy-Induced Alopecia by Docetaxel: Prevalence, Treatment and Prevention
Abstract
:1. Introduction
- Alopecia, or hair loss, is one of the most common adverse effects associated with docetaxel chemotherapy.
- The fear of chemotherapy-induced alopecia can cause up to 14% of patients to consider rejecting the recommended optimal life-saving cancer treatment.
2. Prevalence of Docetaxel-Induced CIA
- Increased alopecia prevalence is associated with docetaxel dose of >55 mg/m2.
- Increased alopecia prevalence is associated with docetaxel combination therapies.
Docetaxel Dose | Docetaxel Regimen | Cancer Type | Adjunctive Therapy | Prevalence | References |
---|---|---|---|---|---|
Monotherapy | |||||
75 mg/m2 | 10 cycles ^ | Metastatic castration-resistant prostate cancer, n = 379 men, Mean age = 68 | - | 34.3% | [6] |
4 cycles | Non-small cell lung cancer, n = 288, Median age = 57 | - | 37.7% | [22] | |
Not included | Metastatic castration-resistant prostate cancer, n = 49, Median age = 68.5 | - | 42.9% | [23] | |
100 mg/ m2 | 6 cycles | Recurrent breast cancer, n = 6, Mean age = 55 | - | 83.3% | [25] |
Combination Therapy | |||||
40 mg/m2 every 2 weeks * | 12 cycles ^ | Metastatic castration-naïve prostate cancer, n = 35, Median age = 68 | Androgen deprivation therapy | 74% | [26] |
60 mg/m2 | 3 cycles | Locally advanced gastric cancer, n = 20 Mean age = 58.1 | Bevacizumab 7.5 mg/kg Cisplatin 60 mg/m2 Capecitabine 937.5 mg/m2 | 90% | [28] |
75 mg/m2 | 6 cycles ^ | HER-2 positive metastatic breast cancer, n = 276, Mean age = 55.6 | Trastuzumab 600 mg @ Pertuzumab 420 mg/kg | 46.8% | [29] |
6 cycles ^ | Non-small cell lung cancer, n = 9, Mean age = 67 | GSK3052230 # | 44% | [32] | |
4 cycles | Locally advanced or early HER2-negative breast cancer, n = 65, Median age = 52 | Capecitabine 1000 mg/m2 | 76.9% | [27] | |
4 cycles | Locally advanced or early HER2-negative breast cancer, n = 74, Median age = 52 | Epirubicin 75 mg/m2 | 91.4% | [27] | |
4 cycles | Breast cancer, n = 9, Mean age = 49 | Cyclophosphamide 600 mg/m2 | 100% | [12] | |
4 cycles | Early-stage breast cancer, n = 30 Mean age = 53.96 | 96.7% | [31] | ||
85 mg/ m2 | 4 cycles adjunctive, then 4 cycles docetaxel | Locally advanced breast cancer, n = 100, Median age = 47 | Doxorubicin 40 mg/m2 Cyclophosphamide 600 mg/m2 (delivered in PEG-coated liposomes) | 64.3% | [30] |
3. Docetaxel-Induced Persistent or Permanent CIA (pCIA)
- Taxane-based treatment is associated with an eight times greater likelihood of inducing pCIA compared to other chemotherapeutic agents.
- Docetaxel is associated with a higher risk for pCIA than paclitaxel.
4. Treatment for CIA and pCIA
- There is currently no cure for pCIA, and the treatment outcomes are mostly disappointing.
- Various clinical trials are investigating the use of minoxidil, photobiomodulation, or platelet-rich plasma as a treatment for pCIA/CIA.
5. Preventative Measures
- The successful prevention of CIA is classified as <50% hair loss.
- Scalp cooling administered by healthcare professionals remains the only FDA-cleared measure to prevent CIA by docetaxel.
Miscellaneous Novel Options
6. Research Models of CIA
- Ex vivo and in vivo models of CIA have been developed to get a better understanding of the underlying mechanisms of CIA and pCIA.
- A limitation of the murine model of CIA is the short anagen duration compared to human scalp HF, making it difficult to recapitulate human HF damage/recovery upon multi-course chemotherapy in the clinic.
7. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Perez, A.M.; Haberland, N.I.; Miteva, M.; Wikramanayake, T.C. Chemotherapy-Induced Alopecia by Docetaxel: Prevalence, Treatment and Prevention. Curr. Oncol. 2024, 31, 5709-5721. https://doi.org/10.3390/curroncol31090423
Perez AM, Haberland NI, Miteva M, Wikramanayake TC. Chemotherapy-Induced Alopecia by Docetaxel: Prevalence, Treatment and Prevention. Current Oncology. 2024; 31(9):5709-5721. https://doi.org/10.3390/curroncol31090423
Chicago/Turabian StylePerez, Aleymi M., Nicole I. Haberland, Mariya Miteva, and Tongyu C. Wikramanayake. 2024. "Chemotherapy-Induced Alopecia by Docetaxel: Prevalence, Treatment and Prevention" Current Oncology 31, no. 9: 5709-5721. https://doi.org/10.3390/curroncol31090423