Scientists discover new breakthrough in cancer hair loss treatment

University of Manchester| September 2019 |Scientists discover new breakthrough in cancer hair loss treatment

Scientists at the University of Manchester have discovered that damage in the hair follicle causing by taxanes cancer drugs which can cause permanent hair loss, can be prevented. Taxanes are very important anti-cancer drugs commonly used to treat, for example, patients with breast or lung carcinoma and particularly cause anxieties among breast cancer patients for the very distressing and sometimes long-lasting hair loss taxanes can induce. 

Source Purba et al 2019
Image source: Purba et al 2019

Lead author of the study Dr Talveen Purba explains:

Dr Purba emphasises: “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 specialised 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. Therefore, we must protect these cells most from undesired chemotherapy effects – but so that the cancer does not profit from it.”

The team hope that their work will support the development of externally applicable medicines that will slow or briefly suspend cell division in the scalp hair follicles of patients undergoing chemotherapy to mitigate against chemotherapy-induced hair damage. This could complement and enhance the efficacy of existing preventive approaches i.e. scalp cooling devices (Source: University of Manchester)

The full new story is available from the University of Manchester

Full reference: Purba, T. S. et al 2019| CDK4/6 inhibition mitigates stem cell damage in a novel model for taxane‐induced alopecia| EMBO molecular medicine| https://doi.org/10.15252/emmm.201911031

Abstract

Taxanes are a leading cause of severe and often permanent chemotherapy‐induced alopecia. As the underlying pathobiology of taxane chemotherapy‐induced alopecia remains poorly understood, we investigated how paclitaxel and docetaxel damage human scalp hair follicles in a clinically relevant ex vivo organ culture model. Paclitaxel and docetaxel induced massive mitotic defects and apoptosis in transit amplifying hair matrix keratinocytes and within epithelial stem/progenitor cell‐rich outer root sheath compartments, including within Keratin 15+ cell populations, thus implicating direct damage to stem/progenitor cells as an explanation for the severity and permanence of taxane chemotherapy‐induced alopecia. Moreover, by administering the CDK4/6 inhibitor palbociclib, we show that transit amplifying and stem/progenitor cells can be protected from paclitaxel cytotoxicity through G1 arrest, without premature catagen induction and additional hair follicle damage. Thus, the current study elucidates the pathobiology of taxane chemotherapy‐induced alopecia, highlights the paramount importance of epithelial stem/progenitor cell‐protective therapy in taxane‐based oncotherapy, and provides preclinical proof‐of‐principle in a healthy human (mini‐) organ that G1 arrest therapy can limit taxane‐induced tissue damage.

 

The article can be read online or downloaded

 

 

 

 

Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

NICE | August 2019 | Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer| Technology Appraisal Guidance

NICE has published Evidence-based recommendations on ribociclib (Kisqali) for hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer in adults who have had previous endocrine therapy.

Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

See also:

Breast cancer drugs option joins cancer drugs fund

 

Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy

NICE |  August 2019 | Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy

Olaparib (Lynparza) is available through the Cancer Drugs Fund. It is a possible treatment for advanced ovarian, fallopian tube or peritoneal cancer in adults, if:

  • they have a BRCA mutation and
  • the cancer has been treated with 1 course of platinum-based chemotherapy.

More evidence on olaparib is being collected, until September 2023. After this, NICE will decide whether or not to recommend it for use on the NHS and update the guidance. It will be available through the Cancer Drugs Fund until then.

Full details from NICE

New lung cancer treatment option approved by NICE

NICE | August 2019| New lung cancer treatment option approved by NICE

NICE has approved another new life-extending treatment for some people with lung cancer is to be made available on the Cancer Drugs Fund (CDF) following its approval by NICE in draft guidance

The immunotherapy drug pembrolizumab (also known as Keytruda) used with chemotherapy drugs carboplatin and paclitaxel will now be an option for adults with squamous non-small-cell lung cancer (NSCLC) which has spread to other parts of the body and who haven’t had any previous treatments.

lungs

Evidence from an ongoing clinical trial suggests that people who have pembrolizumab combination therapy could live longer than those who have standard chemotherapy. It also suggests people could have additional time without their cancer progressing compared with standard chemotherapy.

However, because the clinical evidence is immature, the cost-effectiveness estimates for pembrolizumab combination therapy are very uncertain. The committee recognised that it has the potential to be cost-effective, and therefore recommended it for use on the CDF. This will allow more evidence to be collected to address the uncertainties around overall survival.

Director of the NICE Centre for Health Technology Evaluation Meindert Boysen, said: ““The committee heard from the patient experts that people with squamous non-small-cell lung cancer often have a poor quality of life, and that treatments that have the potential to extend life would be of great importance.” (Source: NICE)

Full press release available from NICE

Read the draft guidance on pembrolizumab here

[NICE Appraisal consultation] Approval for treatment option for early breast cancer after adjuvant trastuzumab [ID981]

NICE | August 2019| Approval for treatment option for early breast cancer after adjuvant trastuzumab [ID981]

Today (7 August 2019) The National Institute for Health and Care Excellence (NICE) has published draft guidance recommending neratinib as an additional treatment for some people with early hormone- receptor-positive human epidermal growth factor receptor 2 (HER2)- positive breast cancer. 

In a press release, NICE recommends Neratinib (also called Nerlynx and marketed by Pierre Fabre), under the terms of a commercial arrangement, for people with this type of breast cancer who are less than 1 year from completing trastuzumab (Herceptin)-based treatment following surgery (called adjuvant treatment).

The clinical trial evidence showed that people who had treatment with neratinib have less risk of disease recurrence than people who had treatment with a placebo. Despite there being no available data about how this might translate into increasing the overall length of time people live, the committee concluded that the cost-effectiveness estimates for neratinib made it an acceptable use of NHS resources.

Meindert Boysen, director of the Centre for Health Technology Evaluation at NICE, said: “Breast cancer remains the most common form of cancer in the UK, accounting for around 30% of all cancers in women. And although there have been advances in the treatment of early stage HER2-positive breast cancer, around a quarter of people treated with trastuzumab following surgery will have a recurrence of their cancer.

“We are therefore pleased to be able to recommend neratinib as a further treatment option for people with this type of breast cancer, based on the benefits it provides in extending the time before the disease gets worse and on its important potential to reduce the risk of the cancer returning.”

Neratinib, which is taken as 6 x 40 mg tablets daily for 1 year, is recommended provided trastuzumab is the only HER2-directed adjuvant treatment people have had (Source: NICE).

The guidance is in development, comments can be made via the  Appraisal consultation

The closing date for comments is Wednesday 28 August 2019

Related:

NICE [press release] NICE recommends additional treatment option for people with early breast cancer   NICE

See also:

OnMedica Approval for treatment option for early breast cancer 

 

 

Breast cancer drugs option joins cancer drugs fund

A potentially life-extending drug combination for some people with advanced breast cancer will now be available under the cancer drugs fund (CDF) following approval by NICE and publication of draft guidance

The draft guidance recommends ribociclib (also called Kisqali and made by Novartis) used with fulvestrant as an option for people with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer who have had previous endocrine therapy.

The positive recommendation follows an improved patient access scheme by the company as part of a commercial arrangement.

Clinical trial evidence suggests that, compared with fulvestrant alone, ribociclib with fulvestrant increases the length of time before the disease progresses. However, it is not known whether ribociclib increases the length of time people live, because the final trial results are not available yet.

The committee recognised that ribociclib with fulvestrant has the potential to be cost-effective, and therefore recommended it for use on the CDF. This will allow more evidence to be collected to address the uncertainties around overall survival and cost-effectiveness.

Full dtail at NICE

[NICE Technology appraisal guidance] Lenalidomide plus dexamethasone for previously untreated multiple myeloma

NICE | June 2019 | Lenalidomide plus dexamethasone for previously untreated multiple myeloma Technology appraisal guidance [TA587]

NICE has published evidence-based recommendations on lenalidomide (Revlimid) plus dexamethasone for previously untreated multiple myeloma in adults.

Full details from NICE 

Of interest: [Technology Appraisal Guidance] Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib