1
|
Kuo AMS, Reingold RE, Ketosugbo KF, Pan A, Kraehenbuehl L, Dusza S, Gajria D, Lake DE, Bromberg JF, Traina TA, Fornier MN, Gucalp A, D'Alessandro BM, Rotemberg V, Dauscher M, Shapiro J, Goldfarb SB, Markova A, Lacouture ME. Oral minoxidil for late alopecia in cancer survivors. Breast Cancer Res Treat 2024:10.1007/s10549-024-07440-5. [PMID: 39097564 DOI: 10.1007/s10549-024-07440-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/16/2024] [Indexed: 08/05/2024]
Abstract
PURPOSE Late alopecia, defined as incomplete hair regrowth > 6 months following cytotoxic chemotherapy or > 6 months from initiation of endocrine therapy, negatively impacts quality of life and may affect dose intensity of adjuvant therapy. This study investigates the effect of oral minoxidil in women with chemotherapy and/or endocrine therapy-induced late alopecia. METHODS The rate of clinical response was assessed by standardized photography and quantitated with trichoscopy. RESULTS Two hundred and sixteen patients (mean age 57.8 ± 13.7) were included. The most common cancer diagnosis was breast, in 170 patients (79.1%). Alopecia developed after chemotherapy in 31 (14.4%) patients, endocrine monotherapy in 65 (30.1%) patients, and chemotherapy followed by endocrine therapy in 120 (55.6%) patients. In 119 patients, standardized photography assessments were used to determine clinical change in alopecia after a median of 105 (IQR = 70) days on oral minoxidil and revealed improvement in 88 (74%) patients. Forty-two patients received quantitative trichoscopic assessments at baseline and at follow-up after a median of 91 (IQR = 126) days on oral minoxidil. Patients had clinically and statistically significant increases in frontal hair shaft density (from 124.2 hairs/cm2 at initial to 153.2 hairs/cm2 at follow-up assessment, p = 0.008) and occipital shaft density (from 100.3 hairs/cm2 at initial to 123.5 hairs/cm2 at follow-up assessment. p = 0.004). No patients discontinued oral minoxidil due to adverse events. CONCLUSIONS Overall, oral minoxidil was well tolerated by patients and may benefit both frontal and occipital late alopecia in cancer survivors treated with cytotoxic and/or endocrine therapy by increasing hair shaft and follicle density.
Collapse
Affiliation(s)
- Alyce Mei-Shiuan Kuo
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rachel E Reingold
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kwami F Ketosugbo
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexander Pan
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lukas Kraehenbuehl
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Ludwig Collaborative and Swim Across America Laboratory, Human Oncology and Pathogenesis Program, Department of Medicine, MSKCC, Parker Institute for Cancer Immunotherapy, New York, NY, USA
| | - Stephen Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Devika Gajria
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Diana E Lake
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jacqueline F Bromberg
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tiffany A Traina
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monica N Fornier
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ayca Gucalp
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Veronica Rotemberg
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Megan Dauscher
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USA
| | - Shari B Goldfarb
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alina Markova
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Dermatology Division, Department of Medicine, NYU Grossman Long Island School of Medicine, Mineola, New York, USA.
- Symptom Management Program, Perlmutter Cancer Center, NYU Langone Hospital - Long Island, Mineola, New York, USA.
| |
Collapse
|
2
|
Shim J, Noh H, Kim H, Joo B, Lee J, Oh SJ, Lee JH, Lee D, Lee SK, Park J. Assessment of hair loss and skin changes during treatment in Asian breast cancer patients: A prospective cohort study. J Dermatol 2024; 51:858-862. [PMID: 38293712 DOI: 10.1111/1346-8138.17092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 02/01/2024]
Abstract
With the increasing number of young breast cancer (BC) patients worldwide, concerns about hair loss and skin change persist among BC survivors. This study aimed to evaluate the hair loss and skin changes in Asian BC patients and to compare them according to the treatment regimens. This study enrolled 322 patients scheduled to undergo BC surgery. Hair loss and skin changes were assessed at the following two time points: one day before surgery and 6 months after surgery. Patients who had received systemic anticancer treatment before surgery were assigned to the neoadjuvant treatment group, while patients who were scheduled to receive systemic anticancer treatment were assigned to the adjuvant treatment group. In the adjuvant treatment group, patients with taxane-based chemotherapy had significantly higher odds of increased hair loss, a higher melanin index, and an increased volume of wrinkles (p < 0.0001, p = 0.0110, and p = 0.0371, respectively). In the neoadjuvant treatment group, hair loss was reversed in most patients at 6 months after surgery. Clinicians should inform BC patients about the potential for hair loss and skin changes and provide supportive care to mitigate the effects on the patients' quality of life.
Collapse
Affiliation(s)
- Joonho Shim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyungrye Noh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Heeyeon Kim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byeonghyun Joo
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jongeun Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se Jin Oh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong Hee Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Device Management & Research, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Dongyoun Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se Kyung Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Jihye Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
3
|
Kraehenbuehl L, Kang D, Bang AS, Ketosugbo KF, Hay J, Patil S, Goldfarb S, Cho J, Lacouture ME. Validation and responsiveness of the English version of the Chemotherapy-Induced Alopecia Distress Scale (CADS) in breast cancer patients. Support Care Cancer 2024; 32:369. [PMID: 38773008 PMCID: PMC11108899 DOI: 10.1007/s00520-024-08564-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 05/10/2024] [Indexed: 05/23/2024]
Abstract
PURPOSE This study aimed to validate the Chemotherapy-Induced Alopecia Distress Scale (CADS) in a diverse English-speaking population and patients with endocrine treatment-induced alopecia (EIA). OBJECTIVE Chemotherapy and endocrine therapy commonly cause alopecia in breast cancer patients, leading to significant psychological and social challenges. The CADS was developed to assess the psychosocial impact of alopecia, but its generalizability beyond Korean patients requires further investigation. METHODS Data from the CHANCE study (NCT02530177), which focused on non-metastatic breast cancer, was used. The cohort included 256 patients, and CADS data were collected at baseline, 6 months after chemotherapy completion, or 12 months after initiating endocrine therapy. The CADS questionnaire comprised 17 items covering physical and emotional health, daily activities, and relationships. Reliability was assessed using Cronbach's alpha, and responsiveness was measured by effect size. RESULTS The CADS exhibited good reliability, with Cronbach's alpha of 0.91 for the overall score, indicating acceptable internal consistency in both chemotherapy (0.89) and endocrine therapy (0.86) groups. Longitudinal responsiveness was supported by an effect size of 0.49 between decreasing satisfaction with hair growth and increasing emotional distress. Cross-sectional validity was confirmed, with effect sizes of 0.91 and 0.92 for satisfaction with hair growth and emotional and activity domains, respectively. CONCLUSION The CADS is a valid and responsive tool for assessing the psychosocial impact of chemotherapy-induced alopecia and endocrine treatment-induced alopecia in a diverse Western patient population.
Collapse
Affiliation(s)
- L Kraehenbuehl
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Dermatology, University Hospital Zurich (USZ), University of Zurich (UZH), Raemistrasse 100, 8091, Zurich, Switzerland.
- Department of Pharmacology and Meyer Cancer Center, Weill Cornell Medicine, New York, NY, 10021, USA.
| | - D Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Ro, Gangnam, Seoul, 06351, Republic of Korea
| | - A S Bang
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - K F Ketosugbo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sujata Patil
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - S Goldfarb
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Ro, Gangnam, Seoul, 06351, Republic of Korea.
| | - M E Lacouture
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Dermatology Division, Department of Medicine, NYU Grossman Long Island School of Medicine, NYU Langone Hospital - Long Island, Mineola, NY, 11501, USA
| |
Collapse
|
4
|
Yao T, Li J, Su W, Li X, Liu C, Chen M. The effects of different themes of self-disclosure on health outcomes in cancer patients-A meta-analysis. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2024; 59:267-278. [PMID: 38012069 DOI: 10.1002/ijop.13091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/04/2023] [Indexed: 11/29/2023]
Abstract
Self-disclosure (SD) is a common psychological intervention that involves expressing the patient's feelings and thoughts. The purpose of this study was to assess the effectiveness of different themes of SD on cancer patients. We searched eight databases including PubMed, Cochrane Library Trials, Web of Science, CINAHL, Medline, EMBASE, CNKI and Wanfang from inception to July 2022. Other sources included clinical data registers. The Cochrane Collaboration's tool was used to assess the risk of bias in the included studies. RevMan Analysis software 5.3 was used for data analysis. The protocol of this meta-analysis has been registered on PROSPERO (CRD42022339661). Twenty-two RCTs studies were included. The pooled results demonstrated that self-regulation self-disclosure (SRD) had significant effects on patients' sleep quality, benefit-finding, anxiety and quality of life (QOL), whereas emotional disclosure (ED) did not. Furthermore, enhanced self-regulation self-disclosure (ESRD) or cancer-related self-disclosure (CD) significantly improved patients' QOL, although health education self-disclosure (HED) and positive self-disclosure (PD) did not. Our study suggests that different themes of SD have varied effects on patients, but it remains unclear which themes to use at what point in time. Future research should investigate what themes of SD are adopted at different points in time and the duration of different periods.
Collapse
Affiliation(s)
- Tianying Yao
- Department of Clinical Nursing, School of Nursing, Nanjing Medical University, Nanjing, China
| | - Jiarong Li
- 120 Emergency Command Center, Yantai, China
| | - Wang Su
- Department of Scientific research, Nanjing Medical University, Nanjing, China
| | - Xiaoxuan Li
- Department of Clinical Nursing, School of Nursing, Nanjing Medical University, Nanjing, China
| | - Changying Liu
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mingxia Chen
- Department of Clinical Nursing, School of Nursing, Nanjing Medical University, Nanjing, China
| |
Collapse
|
5
|
Baker R, Dell'Acqua G, Richards A, Thornton MJ. Nutraceuticals known to promote hair growth do not interfere with the inhibitory action of tamoxifen in MCF7, T47D and BT483 breast cancer cell lines. PLoS One 2024; 19:e0297080. [PMID: 38408073 PMCID: PMC10896530 DOI: 10.1371/journal.pone.0297080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/26/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Hair loss/thinning is a common side effect of tamoxifen in estrogen receptor (ER) positive breast cancer therapy. Some nutraceuticals known to promote hair growth are avoided during breast cancer therapy for fear of phytoestrogenic activity. However, not all botanical ingredients have similarities to estrogens, and in fact, no information exists as to the true interaction of these ingredients with tamoxifen. Therefore, this study sought to ascertain the effect of nutraceuticals (+/- estrogen/tamoxifen), on proliferation of breast cancer cells and the relative expression of ERα/β. METHODS Kelp, Astaxanthin, Saw Palmetto, Tocotrienols, Maca, Horsetail, Resveratrol, Curcumin and Ashwagandha were assessed on proliferation of MCF7, T47D and BT483 breast cancer cell lines +/- 17β-estradiol and tamoxifen. Each extract was analysed by high performance liquid chromatography (HPLC) prior to use. Cellular ERα and ERβ expression was assessed by qRT-PCR and western blot. Changes in the cellular localisation of ERα:ERβ and their ratio following incubation with the nutraceuticals was confirmed by immunocytochemistry. RESULTS Estradiol stimulated DNA synthesis in three different breast cancer cell lines: MCF7, T47D and BT483, which was inhibited by tamoxifen; this was mirrored by a specific ERa agonist in T47D and BT483 cells. Overall, nutraceuticals did not interfere with tamoxifen inhibition of estrogen; some even induced further inhibition when combined with tamoxifen. The ERα:ERβ ratio was higher at mRNA and protein level in all cell lines. However, incubation with nutraceuticals induced a shift to higher ERβ expression and a localization of ERs around the nuclear periphery. CONCLUSIONS As ERα is the key driver of estrogen-dependent breast cancer, if nutraceuticals have a higher affinity for ERβ they may offer a protective effect, particularly if they synergize and augment the actions of tamoxifen. Since ERβ is the predominant ER in the hair follicle, further studies confirming whether nutraceuticals can shift the ratio towards ERβ in hair follicle cells would support a role for them in hair growth. Although more research is needed to assess safety and efficacy, this promising data suggests the potential of nutraceuticals as adjuvant therapy for hair loss in breast cancer patients receiving endocrine therapy.
Collapse
Affiliation(s)
- Richard Baker
- Centre for Skin Sciences, Faculty of Life Sciences, University of Bradford, Bradford, United Kingdom
| | | | | | - M Julie Thornton
- Centre for Skin Sciences, Faculty of Life Sciences, University of Bradford, Bradford, United Kingdom
| |
Collapse
|
6
|
de Sousa CFPM, Pereira AAL, Arruda GV, Gouveia AG, Hanna SA, Cruz MRDS, Dos Anjos CH, Bevilacqua JLB, Alcantara Filho P, de Moraes FY, Marta GN. Real-World Evidence on the Use of Endocrine Therapy for Ductal Carcinoma In Situ in Patients Treated With Breast-Conserving Surgery Followed by Postoperative Radiation Therapy: A Brazilian Retrospective Cohort Study. Clin Breast Cancer 2023; 23:e499-e506. [PMID: 37758557 DOI: 10.1016/j.clbc.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/06/2023] [Accepted: 08/20/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION/BACKGROUND This study aims to evaluate the reproducibility of findings from randomized controlled trials regarding adjuvant hormone therapy (HT) for breast ductal carcinoma in situ (DCIS) in a real-life scenario. MATERIALS/METHODS This retrospective cohort study used Fundação Oncocentro de São Paulo database. It included DCIS patients DCIS who received breast-conserving surgery and postoperative radiation therapy. The endpoints were local control (LC), breast cancer-specific survival (BCSS), and overall survival (OS). RESULTS We analyzed 2192 patients treated between 2000 and 2020. The median FU was 48.99 months. Most patients (53.33%; n = 1169) received adjuvant HT. Patients not receiving adjuvant HT tend to be older (P = .021) and have a lower educational level (P < .001). At the end of FU, 1.5% of patients had local recurrence, and there was no significant difference between groups (P = .19). The 10-year OS and BCSS were 89.4% and 97.5% for adjuvant HT versus 91.5% and 98.5% for no adjuvant HT, respectively, and there were no significant differences between groups. The 10-year OS was 93.25% for medium/high education level versus 87.31% for low (HR for death 0.51; 95% CI, 0.32-0.83; P = .007). CONCLUSIONS The benefits of adjuvant HT for DCIS were not reproduced in a Brazilian cohort. Education significantly impacted survival and HT usage, reflecting the influence of socioeconomic factors. These findings can allow for more precise interventions.
Collapse
MESH Headings
- Female
- Humans
- Antineoplastic Agents, Hormonal/therapeutic use
- Brazil/epidemiology
- Breast Neoplasms/pathology
- Carcinoma, Intraductal, Noninfiltrating/drug therapy
- Carcinoma, Intraductal, Noninfiltrating/radiotherapy
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Mastectomy, Segmental
- Neoplasm Recurrence, Local/pathology
- Radiotherapy, Adjuvant
- Randomized Controlled Trials as Topic
- Reproducibility of Results
- Retrospective Studies
- Cohort Studies
Collapse
Affiliation(s)
| | | | - Gustavo Viani Arruda
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP, Ribeirão Preto, SP, Brazil
| | - Andre Guimaraes Gouveia
- Department of Oncology, Division of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada
| | | | | | | | | | | | | | - Gustavo Nader Marta
- Department of Radiation Oncology, Hospital Sírio Libanês, São Paulo, SP, Brazil; Latin America Cooperative Oncology Group (LACOG), Porto Alegre, RS, Brazil
| |
Collapse
|
7
|
Minta A, Rose L, Park C, Ramaswamy B, Stover D, Gatti-Mays M, Cherian M, Williams N, Sudheendra P, Wesolowski R, Sardesai S, Lustberg M, Loprinzi CL, Ruddy KJ, Cathcart-Rake E, Trovato S, Dulmage B. Retrospective cohort study of CDK4/6-inhibitor-induced alopecia in breast cancer patients. Support Care Cancer 2023; 31:717. [PMID: 37991653 DOI: 10.1007/s00520-023-08160-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 11/03/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE Dermatologic adverse events commonly result in the interruption of oncologic treatment, and targeted therapies are the most frequently interrupted class of anticancer agents. Alopecia is a common cutaneous adverse event reported with CK4/6i therapy. Though the clinical characteristics and therapeutic response of EIA have been well documented, few studies have characterized alopecia in patients treated with CDK4/6i. METHODS This study analyzed a retrospective cohort of 28 breast cancer patients diagnosed with endocrine-induced alopecia (EIA) or CDKiA. Comparative analysis of the clinical characteristics of alopecia and therapeutic response to minoxidil was conducted. Therapeutic response to minoxidil (LDOM or topical [5%] solution or foam) was assessed by both Dean Scale and qualitative clinical improvement by comparison of pretreatment and posttreatment clinical images by single-blinded, board-certified academic dermatologists (ST and BD). RESULTS CDKiA was clinically similar to androgenetic alopecia and specific vertex involvement was more common in patients treated with CDK4/6i + ET than endocrine monotherapy (n = 7 [70.0%] vs n = 4 [36.4%]; p = 0.04), respectively. After 4-6 months of minoxidil, there was a moderate to significant qualitative alopecia improvement in 80% of CDKiA patients versus 94.4% of EIA patients. Additionally, superior improvement of mean Dean Score grade was observed in EIA (with change from pre- to posttreatment - 0.44; p = 0.0002). CONCLUSION Compared to endocrine monotherapy, patients on combination CDK4/6i + ET had greater extent of vertex involvement and were more recalcitrant to minoxidil. The preferential vertex involvement observed in CDKiA suggests that combination therapy with minoxidil and topical antiandrogens with poor systemic absorption should be studied in this setting.
Collapse
Affiliation(s)
- Abena Minta
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Lucy Rose
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Candice Park
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Bhuvaneswari Ramaswamy
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Daniel Stover
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Margaret Gatti-Mays
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Mathew Cherian
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Nicole Williams
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Preeti Sudheendra
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Robert Wesolowski
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sagar Sardesai
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Maryam Lustberg
- Department of Medical Oncology, Yale Cancer Center, New Haven, CT, USA
| | | | - Kathryn J Ruddy
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Stephanie Trovato
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| |
Collapse
|
8
|
Kraehenbuehl L, Kang D, Bang AS, Ketosugbo KF, Hay J, Patil S, Goldfarb S, Cho J, Lacouture ME. Validation and Responsiveness of the English version of the Chemotherapy-Induced Alopecia Distress Scale (CADS) in Breast Cancer Patients. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.05.23298093. [PMID: 37986836 PMCID: PMC10659502 DOI: 10.1101/2023.11.05.23298093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Purpose This study aimed to validate the chemotherapy-induced alopecia distress scale (CADS) in a diverse English-speaking population and patients with endocrine treatment- induced alopecia (EIA). Objective Chemotherapy and endocrine therapy commonly cause alopecia in breast cancer patients, leading to significant psychological and social challenges. The CADS was developed to assess the psychosocial impact of alopecia, but its generalizability beyond Korean patients requires further investigation. Methods Data from the CHANCE study ( NCT02530177 ), which focused on non-metastatic breast cancer, was used. The cohort included 256 patients, and CADS data were collected at baseline, six months after chemotherapy completion, or 12 months after initiating endocrine therapy. The CADS questionnaire comprised 17 items covering physical and emotional health, daily activities, and relationships. Reliability was assessed using Cronbach's alpha, and responsiveness was measured by effect size. Results The CADS exhibited good reliability, with a Cronbach's alpha of 0.91 for the overall score, indicating acceptable internal consistency in both chemotherapy (0.89) and endocrine therapy (0.86) groups. Longitudinal responsiveness was supported by an effect size of 0.49 between decreasing satisfaction with hair growth and increasing emotional distress. Cross-sectional validity was confirmed, with effect sizes of 0.91 and 0.92 for satisfaction with hair growth and emotional and activity domains, respectively. Conclusion The CADS is a valid and responsive tool for assessing the psychosocial impact of chemotherapy-induced alopecia and endocrine treatment-induced alopecia in a diverse Western patient population.
Collapse
|
9
|
Minta A, Park C, Rose L, Trovato S, Dulmage B. Retrospective review of oral and topical minoxidil for cancer treatment-induced hair loss. Arch Dermatol Res 2023; 315:2613-2615. [PMID: 37421421 DOI: 10.1007/s00403-023-02660-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/25/2023] [Accepted: 06/25/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Abena Minta
- Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, Gahanna, OH, 43230, USA
| | - Candice Park
- Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, Gahanna, OH, 43230, USA
| | - Lucy Rose
- Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, Gahanna, OH, 43230, USA
| | - Stephanie Trovato
- Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, Gahanna, OH, 43230, USA
| | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, Gahanna, OH, 43230, USA.
| |
Collapse
|
10
|
Cucciniello L, Garufi G, Di Rienzo R, Martinelli C, Pavone G, Giuliano M, Arpino G, Montemurro F, Del Mastro L, De Laurentiis M, Puglisi F. Estrogen deprivation effects of endocrine therapy in breast cancer patients: Incidence, management and outcome. Cancer Treat Rev 2023; 120:102624. [PMID: 37751658 DOI: 10.1016/j.ctrv.2023.102624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
Endocrine therapy is one of the standard adjuvant treatments to reduce the risk of recurrence and mortality in patients with hormone receptor positive early breast cancer. Despite its proven efficacy, ET side effects, which persist over time even if low grade, may deteriorate quality of life. During follow-up visits, emphasis is generally placed on the risk of disease recurrence, while the topic of ET side effects is commonly neglected and discussed only briefly. This could lead to poor adherence to therapy and early treatment discontinuation, resulting in worse survival outcomes. The aim of this review is to provide an overview of the available evidence on the incidence and reporting of ET-related side effects (including vasomotor symptoms, musculoskeletal disorders and genitourinary syndrome of menopause, as well as fatigue, psychological and ocular disorders, dysmetabolic effects and loss of bone density) and of the pharmacological and non-pharmacological strategies available to mitigate symptom burden.
Collapse
Affiliation(s)
- Linda Cucciniello
- Department of Medicine, University of Udine, Udine, Italy; Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
| | - Giovanna Garufi
- Department of Medical Oncology, Università Cattolica del Sacro Cuore, Rome, Italy; Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.
| | - Rossana Di Rienzo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Claudia Martinelli
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Giuliana Pavone
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | | | - Lucia Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy; Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | | | - Fabio Puglisi
- Department of Medicine, University of Udine, Udine, Italy; Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
| |
Collapse
|
11
|
Cathcart-Rake EJ, Tevaarwerk AJ, Haddad TC, D'Andre SD, Ruddy KJ. Advances in the care of breast cancer survivors. BMJ 2023; 382:e071565. [PMID: 37722731 DOI: 10.1136/bmj-2022-071565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Breast cancer survivors may experience significant after effects from diagnoses of breast cancer and cancer directed therapies. This review synthesizes the evidence about optimal management of the sequelae of a diagnosis of breast cancer. It describes the side effects of chemotherapy and endocrine therapy and evidence based strategies for management of such effects, with particular attention to effects of therapies with curative intent. It includes strategies to promote health and wellness among breast cancer survivors, along with data to support the use of integrative oncology strategies. In addition, this review examines models of survivorship care and ways in which digital tools may facilitate communication between clinicians and patients. The strategies outlined in this review are paramount to supporting breast cancer survivors' quality of life.
Collapse
|
12
|
Sibaud V, Sollena P. Dermatologic toxicities to inhibitors of cyclin-dependent kinases CDK 4 and 6: An updated review for clinical practice. Ann Dermatol Venereol 2023; 150:208-212. [PMID: 37586898 DOI: 10.1016/j.annder.2022.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/01/2022] [Accepted: 11/17/2022] [Indexed: 08/18/2023]
Abstract
Cyclin-dependent kinase (CDK) 4/6 inhibitors (palbociclib, ribociclib and abemaciclib) have revolutionized the treatment of metastatic breast carcinoma. They currently form the first-line treatment, in combination with endocrine agents, for the management of locally advanced or metastatic hormone receptor-positive (HR + ), human epidermal growth factor receptor 2-negative (HER2-) breast cancer, the largest subtype of breast carcinoma. CDK 4/6 inhibitors have shown comparable efficacy outcomes with predictable and manageable adverse events. In this setting, dermatologic toxicity appears to be relatively frequent, accounting for up to 15% of all reported adverse events. It is usually mild to moderate in intensity and does not normally constitute a dose-limiting toxicity. The range of dermatologic adverse events includes both non-specific entities (maculopapular rash, pruritus, alopecia) and more characteristic toxicities related to CDK4/6 inhibitors, such as vitiligo-like lesions or cutaneous lupus erythematosus. Finally, more severe or life-threatening skin reactions can occasionally occur. The main dermatologic manifestations associated with CDK4/6 inhibitors, as well as management thereof, are described in this comprehensive review.
Collapse
Affiliation(s)
- V Sibaud
- Oncodermatology, Claudius Regaud Institute and University Cancer Institute, Toulouse Oncopole - 1 Avenue Irène Joliot-Curie 31059, Toulouse Cedex 9, France.
| | - P Sollena
- UOC Dermatologia, Fondazione Policlinico Universitario A.Gemelli-IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| |
Collapse
|
13
|
Alhanshali L, Buontempo M, Shapiro J, Lo Sicco K. Medication-induced hair loss: An update. J Am Acad Dermatol 2023; 89:S20-S28. [PMID: 37591561 DOI: 10.1016/j.jaad.2023.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/24/2023] [Accepted: 04/06/2023] [Indexed: 08/19/2023]
Abstract
This article discusses drug-induced hair loss, which can occur with many drugs including cytotoxic agents, biologics, and immunomodulating agents, among others. It outlines the diagnosis and management of drug-induced alopecia, with a focus on recently implicated drugs.
Collapse
Affiliation(s)
- Lina Alhanshali
- Department of Dermatology, SUNY Downstate College of Medicine, Brooklyn, New York
| | - Michael Buontempo
- Department of Dermatology, Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York.
| |
Collapse
|
14
|
Sollena P, Vasiliki N, Kotteas E, Stratigos AJ, Fattore D, Orlandi A, Mannino M, Di Pumpo M, Fida M, Starace M, Apalla Z, Romano MC, Riganti J, Segura S, Martinez AF, Fabbrocini G, Sibaud V, Peris K, On Behalf Of The Eadv Task Force Dermatology For Cancer Patients. Cyclin-Dependent Kinase 4/6 Inhibitors and Dermatologic Adverse Events: Results from the EADV Task Force "Dermatology for Cancer Patients" International Study. Cancers (Basel) 2023; 15:3658. [PMID: 37509319 PMCID: PMC10377938 DOI: 10.3390/cancers15143658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/29/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The introduction of cyclin-dependent kinase inhibitors (CDK4/6i) was a great advance in therapeutics for patients with estrogen receptor+/human epidermal growth factor receptor (HER2) locally advanced and metastatic breast cancer. Despite the increasing use of these agents, their adverse drug-related events have not yet been fully characterized. We describe the spectrum of cutaneous adverse reactions occurring in advanced breast cancer patients treated with cyclin-dependent kinase inhibitors, analyzing types, severity, time to onset, and possible treatment outcomes. METHODS We performed a multicentric retrospective study including patients with advanced breast cancer who developed cutaneous lesions during treatment with CDK4/6i in the period from June 2020 to June 2021. Patients > 18 years were recruited at eleven onco-dermatology units located in Albania (1), Argentina (1), France (1), Greece (3), Italy (3), and Spain (2). We evaluated patients' epidemiological and clinical characteristics, types of cutaneous adverse events, their time to onset, and treatment outcomes. The severity of the skin reactions was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 score. RESULTS Seventy-nine patients (median age: 62.3 years; range 39-83 years) were included in the study, and, collectively, we recorded a total of 165 cutaneous adverse events during follow-up visits. The most frequent cutaneous reactions were pruritus (49/79 patients), alopecia (25/79), and eczematous lesions (24/79). Cutaneous toxicities were usually mild in severity (>65%) and occurred after a median of 6.5 months. Only four patients (5%) required treatment discontinuation due to the severity of the skin lesions. The majority of the skin reactions were managed with topical treatments. CONCLUSIONS To the best of our knowledge, we present the largest case series of cutaneous adverse events developing in advanced breast cancer patients treated with CDK4/6i. We showed that cutaneous toxicities are usually mild in severity, and manageable with standard supportive care; however, in selected cases, they can lead to treatment discontinuation with possible implications for patients' clinical outcomes.
Collapse
Affiliation(s)
- Pietro Sollena
- UOC Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Nikolaou Vasiliki
- Dermato-Oncology Department, Cutaneous Toxicities Clinic, Andreas Sygros Hospital, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Elias Kotteas
- Oncology Unit, 3rd Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, "Sotiria" General Hospital, 16121 Athens, Greece
| | - Alexander J Stratigos
- Dermato-Oncology Department, Cutaneous Toxicities Clinic, Andreas Sygros Hospital, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Davide Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80126 Naples, Italy
| | - Armando Orlandi
- Medical Oncology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Maria Mannino
- Dermatologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marcello Di Pumpo
- Department of Scienza della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Monika Fida
- Dermatology Service, University Hospital Center "Mother Theressa", 1005 Tirana, Albania
| | - Michela Starace
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Zoe Apalla
- Second Dermatology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | | | - Julia Riganti
- Dermatology Department, Hospital Italiano de Buenos Aires, 1199 Buenos Aires, Argentina
| | - Sonia Segura
- Department of Dermatology, Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), 08003 Barcelona, Spain
| | - Azael Freites Martinez
- Oncodermatology Clinic at Hospital Ruber Juan Bravo and Universidad Europea, 28006 Madrid, Spain
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80126 Naples, Italy
| | - Vincent Sibaud
- Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, 31500 Toulouse, France
| | - Ketty Peris
- UOC Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | |
Collapse
|
15
|
Fhager J, Svensson Å, Örmon K, Fischer TW, Sjöström K. The Hairdex quality of life instrument-A translation and psychometric validation in patients with alopecia areata. SKIN HEALTH AND DISEASE 2023; 3:e220. [PMID: 37275410 PMCID: PMC10233165 DOI: 10.1002/ski2.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 09/20/2024]
Abstract
Background The German Hairdex quality of life (QoL) instrument is specific to hair and scalp diseases, developed for self-rating and consists of 48 statements divided into five domains: Symptoms, Functioning, Emotions, Self-confidence and Stigmatisation. There was a need of a Swedish reliability tested, validated hair and scalp specific QoL instrument why the German Hairdex was chosen to be translated and reliability tested in a systematic way. Objectives To make a translation, a reliability test of stability, and validation of the German Hairdex QoL instrument among 100 Swedish patients with a dermatological ICD-10 diagnosis of alopecia areata (AA). Methods An eight-step method by Gudmundsson was used as a model with a forward and backward translation and with comments from an expert panel. A statistical test-retest (ICC (2,1)) analysis was made, followed by an internal consistency analysis. A comparison between the German and Swedish Hairdex-S constructs by a principal component analysis was performed. Results The Hairdex-S was very well accepted by patients. The ICC(2,1) test-retest showed a good to excellent correlation of 0.91 (CI [0.85-0.95]). Internal consistency was α = 0.92. Like the original Hairdex, Hairdex-S showed good factorability with a Kaiser-Meyer-Olkin measure of 0.82 and with one component explaining 70% of the variance: original Hairdex instrument (69%). When tested on patients with AA, the domains Functioning and Emotions had the strongest loadings, followed by Stigmatisation and Self-confidence. Younger AA patients at self-assessment and patients who reported to be younger at the onset of AA, scored statistically significantly higher on the Hairdex-S, indicating an overall lower QoL on domains Emotions and Functioning, respectively. Conclusions The Hairdex-S is very well accepted by AA patients, shows very good psychometric properties, and a very good agreement with the original Hairdex. The Swedish Hairdex instrument can be recommended for evaluation of patients QoL as well as for research purposes.
Collapse
Affiliation(s)
- Johan Fhager
- Department of Care ScienceMalmö UniversityMalmöSweden
| | - Åke Svensson
- Department of Dermatology and VenereologyLund UniversitySkåne University HospitalLundSweden
| | - Karin Örmon
- Department of Care ScienceMalmö UniversityMalmöSweden
| | - Tobias W. Fischer
- Department of Dermatology and VenereologyKepler University HospitalJohannes Kepler UniversityLinzAustria
| | | |
Collapse
|
16
|
Lee YY, Sung YK, Hong D, Jung KE, Seo YJ, Lee Y. A case of aromatase inhibitor-induced alopecia successfully treated with low-dose oral minoxidil. J Cosmet Dermatol 2023. [PMID: 36924357 DOI: 10.1111/jocd.15729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Young Yoon Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Yeoun Kuk Sung
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Dongkyun Hong
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Kyung Eun Jung
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young-Joon Seo
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| |
Collapse
|
17
|
Rose L, Lustberg M, Ruddy KJ, Cathcart-Rake E, Loprinzi C, Dulmage B. Hair loss during and after breast cancer therapy. Support Care Cancer 2023; 31:186. [PMID: 36826602 DOI: 10.1007/s00520-023-07634-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
For patients diagnosed with breast cancer, alopecia can be a distressing side effect of treatment. Major surgeries, cytotoxic chemotherapy, and endocrine therapy may result in several different types of alopecia. This article reviews the underlying mechanisms, etiology, prevention strategies, and treatment options for chemotherapy-induced alopecia, telogen effluvium, and endocrine-induced alopecia. Here, we aim to provide breast oncologists with a review of the types of hair loss related to cancer therapy and current preventative and treatment options to facilitate informative patient counseling.
Collapse
Affiliation(s)
- Lucy Rose
- The Ohio State University College of Medicine, Columbus, OH, USA
| | | | | | | | | | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| |
Collapse
|
18
|
Evidence-Based Guidance for Breast Cancer Survivorship. Hematol Oncol Clin North Am 2023; 37:225-243. [PMID: 36435612 DOI: 10.1016/j.hoc.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Breast cancer survivorship care includes management of lingering physical symptoms, supports to address the emotional toll exacted by a cancer diagnosis and cancer therapies, monitoring and optimization of cardiac and bone health, general wellness promotion, reproductive health care, surveillance for cancer recurrence, care coordination, and efforts to mitigate health disparities.
Collapse
|
19
|
Fontanella C, Giorgi CA, Russo S, Angelini S, Nicolardi L, Giarratano T, Frezzini S, Pestrin M, Palleschi D, Bolzonello S, Parolin V, Haspinger ER, De Rossi C, Greco F, Gerratana L. Optimizing CDK4/6 inhibitors in advanced HR+/HER2- breast cancer: A personalized approach. Crit Rev Oncol Hematol 2022; 180:103848. [DOI: 10.1016/j.critrevonc.2022.103848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 09/20/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
|
20
|
Villani A, Ferrillo M, Fabbrocini G, Ocampo-Garza SS, Scalvenzi M, Ruggiero A. Hair Aging and Hair Disorders in Elderly Patients. Int J Trichology 2022; 14:191-196. [PMID: 37034552 PMCID: PMC10075351 DOI: 10.4103/ijt.ijt_90_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 03/16/2023] Open
Abstract
Hair loss in elderly patients is a common complaint. It can be related to different conditions that affect patients' quality of life and represents a challenge for dermatologists. It affects both men and women during the aging process with an estimated percentage of balding after 65 years of age of 53% and 37%, respectively. Androgenetic alopecia, frontal fibrosing alopecia, senile alopecia, and erosive pustular dermatosis of the scalp are the hair diseases most frequently described in this age group. The objective of this review is to summarize the current knowledge about alopecia affecting elderly patients, differentiating between chronological hair aging signs and pathological changes, to help clinicians, offer an adequate management of these disorders to their patients.
Collapse
Affiliation(s)
- Alessia Villani
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Maria Ferrillo
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Sonia Sofía Ocampo-Garza
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
- Department of Dermatology, University Hospital “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Massimiliano Scalvenzi
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| |
Collapse
|
21
|
Freites-Martinez A, Shapiro J. Diagnosis of Persistent Chemotherapy-Induced Alopecia in Breast Cancer Survivors. JAMA Dermatol 2022; 158:704. [PMID: 35507353 DOI: 10.1001/jamadermatol.2022.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York
| |
Collapse
|
22
|
Art of prevention: The importance of dermatologic care when using aromatase inhibitors. Int J Womens Dermatol 2022; 7:769-773. [PMID: 35028380 PMCID: PMC8714559 DOI: 10.1016/j.ijwd.2021.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/05/2021] [Accepted: 07/10/2021] [Indexed: 11/24/2022] Open
Abstract
As of January 2021, there are more than 3.8 million women in the United States with a history of breast cancer. The current standard of care for breast cancer involves surgical resection, radiation therapy, adjuvant endocrine therapy, and/or adjuvant chemotherapy. Aromatase inhibitors (AIs) are the gold standard for endocrine therapy in postmenopausal women. Dermatologic adverse events (dAEs) associated with AIs are rare but have been reported in the literature. Commonly reported dAEs include unspecified rash, pruritus, alopecia, vulvovaginal atrophy, vasculitis, and autoimmune/connective tissue disorders. Appropriate preventative strategies and careful management considerations have the potential to optimize the comprehensive care of patients with cancer and improve quality of life. Furthermore, prevention of dAEs can lead to a reduction in cancer treatment interruptions and discontinuations. Herein, we characterize dAEs of AIs and discuss preventative management to reduce the incidence of AI therapy interruption.
Collapse
|
23
|
Cancer-Related Alopecia: From Etiologies to Global Management. Cancers (Basel) 2021; 13:cancers13215556. [PMID: 34771716 PMCID: PMC8583126 DOI: 10.3390/cancers13215556] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Although it does not represent a condition that threatens the life of patients, alopecia nevertheless has an essential impact on the quality of life of patients, particularly in terms of the psychological and social aspects. Indeed, while it has long been considered an acceptable side effect in the management of patients, the progressive emergence of a patient-centered approach coupled with a better knowledge of the pathophysiological processes involved has led to a better consideration of alopecia, both on the preventive and palliative sides. Thus, cancerous alopecia can be multifactorial: iatrogenic (in particular via conventional chemotherapy), induced by a vitamin/nutritional deficiency, or even caused by the disease itself. In this state-of-the-art review, we therefore cover alopecia in an exhaustive manner by considering the different mechanisms involved and their frequency as well as the various therapies offered. Abstract Alopecia represents a multifaceted challenge with distinct etiologies and consequences. Transposed to the world of oncology, different types of alopecia and molecular pathways have been characterized, allowing a better understanding of the underlying mechanisms. In patients with cancer, alopecia can be iatrogenic (i.e., due to conventional chemotherapies, endocrine therapies, targeted therapies, immunotherapies, radiotherapy and surgery) or a direct consequence of the disease itself (e.g., malnutrition, scalp metastases and paraneoplastic syndromes). Identification of the actual incriminated mechanism(s) is therefore essential in order to deliver appropriate supportive care, whether preventive or curative. On the preventive side, the last few years have seen the advent of the automated cooling cap, a prophylactic approach supported by several randomized clinical trials. On the curative side, although the treatments currently available are limited, several promising therapeutic approaches are under development. Appropriate alopecia management is essential, particularly regarding its psychological repercussions with significant consequences on the quality of life of patients and their family and with a potential impact on treatment compliance.
Collapse
|
24
|
Bhoyrul B, Asfour L, Lutz G, Mitchell L, Jerjen R, Sinclair RD, Holmes S, Chaudhry IH, Harries MJ. Clinicopathologic Characteristics and Response to Treatment of Persistent Chemotherapy-Induced Alopecia in Breast Cancer Survivors. JAMA Dermatol 2021; 157:1335-1342. [PMID: 34586345 DOI: 10.1001/jamadermatol.2021.3676] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Importance Alopecia induced by classic chemotherapy affects up to 65% of patients and is usually reversible. However, there are increasing reports of persistent chemotherapy-induced alopecia (pCIA), especially for patients treated with taxane-containing chemotherapy regimens. Objective To analyze the clinicopathologic characteristics and response to treatment of patients with pCIA after chemotherapy for breast cancer. Design, Setting, and Participants In this case series, a retrospective evaluation was performed of patients with a diagnosis of pCIA after chemotherapy for breast cancer in 4 specialist hair clinics from November 1, 2011, to February 29, 2020. Main Outcomes and Measures Clinical, trichoscopic, and histopathologic characteristics and treatment outcomes were analyzed. For patients who presented with diffuse alopecia or diffuse rarefaction of hair over the midfrontal scalp with widening of the central part line and preservation of the frontal hairline, the Sinclair scale (grades 1-5, where 1 indicates normal hair density and 5 indicates the most severe stage of hair loss, with little or no hair in the centroparietal region) was used to assess severity. Results One hundred patients (99 women [99%]; mean age at presentation, 54.0 years [range, 29.0-74.1 years]) were included. Most patients had diffuse nonscarring alopecia (n = 39), female pattern hair loss (n = 55), or male pattern hair loss (n = 6). Six patients developed cicatricial alopecia. Taxane-containing regimens were used for most patients (92 [92%]) and were associated with more severe alopecia than regimens that did not contain taxanes (median Sinclair grade, 4 [IQR, 3-5] vs 2 [IQR, 2-2.5]; P < .001). A total of 76 of 86 patients (88%) had trichoscopic signs indistinguishable from those of androgenetic alopecia. Of 18 patients who had biopsies, 14 had androgenetic alopecia-like features, 2 had cicatricial alopecia, and 2 had features of both. Both topical and oral minoxidil, sometimes combined with antiandrogen therapy, were associated with an improvement in hair density (median Sinclair grade, 4 [IQR, 3-5] before treatment vs 3 [IQR, 2-4] after treatment; P < .001). Conclusions and Relevance This case series outlines previously unreported features of pCIA in patients with breast cancer, including a trichoscopic description. Cosmetically significant regrowth was achieved for a significant proportion of patients with topical or systemic treatments, suggesting that pCIA may be at least partly reversible.
Collapse
Affiliation(s)
| | - Leila Asfour
- The Dermatology Centre, Salford Royal National Health Service Foundation Trust, Salford, Greater Manchester, United Kingdom
| | - Gerhard Lutz
- Hair and Nail Medicine, Bonn, Germany.,Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany
| | - Lorne Mitchell
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | | | - Rodney D Sinclair
- Sinclair Dermatology, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Susan Holmes
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Iskander H Chaudhry
- Department of Histopathology, Royal Liverpool and Broadgreen University Hospitals National Health Service Trust, Liverpool, United Kingdom
| | - Matthew J Harries
- The Dermatology Centre, Salford Royal National Health Service Foundation Trust, Salford, Greater Manchester, United Kingdom.,Centre for Dermatology Research, University of Manchester, Manchester Academic Health Science Centre and National Institute for Health Research Manchester Biomedical Research Centre, Manchester, United Kingdom
| |
Collapse
|
25
|
Rossi A, Caro G, Magri F, Fortuna MC, Carlesimo M. Clinical aspect, pathogenesis and therapy options of alopecia induced by hormonal therapy for breast cancer. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2021; 2:490-495. [PMID: 36045704 PMCID: PMC9400690 DOI: 10.37349/etat.2021.00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022] Open
Abstract
Adjuvant hormonal therapy is one of the most important treatments of hormone-receptor-positive breast cancer and includes selective estrogen receptor modulators, aromatase inhibitors, and luteinizing hormone-releasing hormone analogs. In patients receiving these drugs, a progressive recession of frontal-temporal hairlines is often observed, such as a certain grade of hair miniaturization in the same areas and the central scalp area, producing a pseudo-female androgenic alopecia, which has to be considered oncotherapy-induced alopecia. The aim of this work, is to describe the clinical aspects and pathogenesis of this type of alopecia and to analyze the different drugs which have been proposed until now. The authors concude that topical hormones should not be considered as a therapeutic approach because of their direct or indirect oncogenic potential. A therapeutic approach that could be both safe and effective is proposed.
Collapse
Affiliation(s)
- Alfredo Rossi
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Gemma Caro
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Francesca Magri
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Maria Caterina Fortuna
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Marta Carlesimo
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| |
Collapse
|
26
|
Jimenez RB, Rabinovitch RA. Caring for the Whole Patient After Breast Cancer Therapy: A Survivorship Guide for Radiation Oncologists. Pract Radiat Oncol 2021; 12:e1-e6. [PMID: 34454104 DOI: 10.1016/j.prro.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022]
Abstract
With 5-year survival rates after breast cancer therapy exceeding 90%, comprehensive follow-up care is a vital component of the treatment plan for patients who have completed active therapy. Although radiation oncologists are generally comfortable with management of the locoregional toxicities of breast cancer radiation therapy, many may be less familiar with the toxicities and available interventions associated with surgery, chemotherapy, and antihormone therapy. For radiation oncologists to provide the greatest value to their patients and play a meaningful role in patients with breast cancer follow-up care, multisystem assessment and management, beyond the breast/chest and axilla, is key. This guide is intended as an educational and practical tool to assist any oncology caregiver with a thorough multisystem assessment and management of the most common survivorship issues for the treated breast cancer patient. Hyperlinks to published data supporting or summarizing the intervention are provided for further reading in the online version, along with sample "Follow-Up Note and After Visit Summary" templates.
Collapse
Affiliation(s)
- Rachel B Jimenez
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
| | - Rachel A Rabinovitch
- Department of Radiation Oncology, University of Colorado Hospital, Denver, Colorado
| |
Collapse
|
27
|
|
28
|
[Alopecia and cancers: From basics to clinical practice]. Bull Cancer 2021; 108:963-980. [PMID: 34304865 DOI: 10.1016/j.bulcan.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/30/2021] [Accepted: 04/19/2021] [Indexed: 11/22/2022]
Abstract
Alopecia, although long considered an unavoidable consequence of cancer therapy, currently presents a multifaceted challenge. The knowledge of the physiology of the hair and consequently of the pathophysiology of alopecia has led to show that there is not one but several types of alopecia. Transposed to the world of oncology, different types of alopecia and subsequently molecular pathways have been characterized, allowing a better understanding of the underlying mechanisms. Thus, in patients with cancer, alopecia can be iatrogenic (chemotherapies, endocrine therapies, targeted therapies, immunotherapies, radiotherapy, surgery) or directly the consequence of the disease itself (malnutrition, scalp metastases, paraneoplastic syndromes). Knowledge of the incriminated mechanism(s) could thus make it possible to deploy an appropriate care component, whether on the preventive or curative sides or in terms of supportive care. These are particularly essential regarding the psychological repercussions caused by alopecia, with significant consequences on the quality of life of patients and with a potential impact on treatment compliance. On the preventive side, the last few years have seen the advent of the automated scalp cooling therapy, supported by several randomized clinical trials. On the curative side, several therapeutic proposals are currently deployed or under development in order to provide relevant treatments.
Collapse
|
29
|
Thadanipon K, Suchonwanit P. Measuring Patient Quality of Life Following Treatment for Alopecia. Patient Prefer Adherence 2021; 15:1601-1610. [PMID: 34295154 PMCID: PMC8292623 DOI: 10.2147/ppa.s282399] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/10/2021] [Indexed: 01/03/2023] Open
Abstract
Alopecia is a challenging problem for both physicians and patients in terms of diagnosis and treatment. Alopecia usually has negative effects on patients' emotional and psychological well-being. Several studies have examined the effect of alopecia on patients' health-related quality of life (HRQoL) and have consistently reported poor scores. However, deeper insight into the impact of alopecia on affected individuals and its measurement using HRQoL questionnaires is lacking in the literature. In this article, the methods for measuring the HRQoL of patients with alopecia were comprehensively reviewed. Their applications and limitations were also discussed.
Collapse
Affiliation(s)
- Kunlawat Thadanipon
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
30
|
Gwark S, Ahn SH, Noh WC, Lee ES, Jung Y, Kim LS, Han W, Nam SJ, Gong G, Kim SO, Kim HJ. Patient-Reported Outcomes From Phase III Neoadjuvant Systemic Trial Comparing Neoadjuvant Chemotherapy With Neoadjuvant Endocrine Therapy in Pre-Menopausal Patients With Estrogen Receptor-Positive and HER2-Negative, Lymph Node-Positive Breast Cancer. Front Oncol 2021; 11:608207. [PMID: 34277393 PMCID: PMC8284076 DOI: 10.3389/fonc.2021.608207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
We aimed to evaluate the patient-reported outcomes (PROs) in a prospective phase III clinical trial, comparing neoadjuvant endocrine therapy (NET) with conventional neoadjuvant chemotherapy (NCT) in patients with hormone status positive, lymph node-positive premenopausal breast cancer (NCT01622361). The patients were randomized prospectively to either 24 weeks of NCT with adriamycin plus cyclophosphamide followed by taxane or NET with gonadotropin-releasing hormone agonist and tamoxifen. The patients were examined at the surgery unit of a large tertiary care hospital with a comprehensive cancer center. PROs were assessed on the first day of the trial (day 1, baseline) and at the end of treatment, using the breast cancer module of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 23 (EORTC QLQ BR23). One hundred and eighty-seven patients were randomly assigned to chemotherapy (n=95) or endocrine therapy (n=92), and 174 patients completed 24 weeks of the neoadjuvant treatment period (n=87, in each group). Baseline scores were similar between the groups. After treatment, there were no statistically significant differences in the function scales, including body image, sexual functioning, and sexual enjoyment between the groups, although the endocrine treatment group showed a significant improvement in the future perspective (hazard ratio, 8.3; 95% confidence interval, 1.72-18.38; P = 0.021). Similarly, there were no statistically significant differences in the symptom scales between the groups, including adverse effects of systemic therapy, breast symptoms, arm symptoms, and upset about hair loss. In conclusion, overall PROs were similar in both treatment groups, except for "future perspective," which was significantly better in the NET group than in the NCT group. CLINICAL TRIAL REGISTRATION ClinicalTrials.Gov, identifier NCT01622361.
Collapse
Affiliation(s)
- Sungchan Gwark
- Department of Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Sei Hyun Ahn
- Department of Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Woo Chul Noh
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Eun Sook Lee
- Department of Surgery, Center for Breast Cancer, Research and Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Yongsik Jung
- Department of Surgery, School of Medicine, Ajou University, Suwon, South Korea
| | - Lee Su Kim
- Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea
| | - Wonshik Han
- Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, South Korea
| | - Seok Jin Nam
- Department of Surgery, School of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Gyungyub Gong
- Department of Pathology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Seon-Ok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea
| | - Hee Jeong Kim
- Department of Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| |
Collapse
|
31
|
Emerging Skin Toxicities in Patients with Breast Cancer Treated with New Cyclin-Dependent Kinase 4/6 Inhibitors: A Systematic Review. Drug Saf 2021; 44:725-732. [PMID: 33959899 DOI: 10.1007/s40264-021-01071-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 12/13/2022]
Abstract
Three cyclin-dependent kinases 4/6, including palbociclib, ribociclib, and abemaciclib, have been approved for the treatment of patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative advanced breast cancer. The objective of this study was to evaluate the occurrence and clinical spectrum of cutaneous adverse events in patients with breast cancer following therapy with cyclin-dependent kinase 4/6 inhibitors. A systematic literature search was performed in the PubMed, Cochrane, and EMBASE databases up to November 2020 to evaluate studies published from 2015 to 2020. Articles were selected by title, abstract, and full text as required. In addition, a manual search was performed from among the references of articles included. Forty-one articles were included with a total of 13 reported dermatologic reactions including alopecia, bullous skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, radiation recall and radiation dermatitis, Henoch-Schonlein purpura, cutaneous leukocytoclastic vasculitis, subacute and chronic cutaneous lupus erythematosus, histiocytoid Sweet syndrome, vitiligo-like lesions, and erythema dyschromicum perstans. Skin toxicity is an important issue because it usually affects a patient's quality of life and could lead to a discontinuation of therapies; therefore, it is of fundamental importance to recognize and adequately manage the adverse skin reactions associated with these types of drugs.
Collapse
|
32
|
Jebahi F, Sharma S, Bloss JE, Wright HH. Effects of tamoxifen on cognition and language in women with breast cancer: A systematic search and a scoping review. Psychooncology 2021; 30:1262-1277. [PMID: 33866625 DOI: 10.1002/pon.5696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Breast cancer treatments bring adverse consequences that interfere with everyday functioning. Importantly, some of these treatments are associated with cognitive and language changes. Tamoxifen is a selective estrogen receptor modulator and is a common endocrine therapy treatment for breast cancer. The current review examines the specific domains of cognition and language affected by the use of tamoxifen in women with breast cancer. METHODS We conducted a systematic search that examined cognitive and/or language functions in chemotherapy-naïve women with breast cancer taking tamoxifen. PubMed, Cochrane CENTRAL, CINAHL Complete, PsycINFO, Scopus, EMBASE, and the Grey Literature Report (greylit.org) were searched. Covidence Systematic Review software (covidence.org) was used to manage the screening process of study titles and abstracts as well as full texts. A total of 17 studies were included in the review. RESULTS A range of cognitive and language domains were reported. These were grouped into seven broad domains: attention, memory, speed, executive functioning, verbal abilities, visual abilities, and language abilities. Results showed that there is compelling evidence that specific domains of memory and speed are negatively affected by the use of tamoxifen. In addition, there was a pattern of change in domains of executive functions and verbal abilities. CONCLUSIONS Tamoxifen affects specific cognitive and language domains. Language domains beyond semantics have not been studied and thus conclusions related to these domains, and language in general, could not be made. Studies exploring the effects of tamoxifen on the different domains of language are recommended.
Collapse
Affiliation(s)
- Fatima Jebahi
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina, USA.,Fulbright Association, Washington, District of Columbia, USA
| | - Saryu Sharma
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina, USA
| | - Jamie E Bloss
- Laupus Library Liaison, East Carolina University, Greenville, North Carolina, USA
| | - Heather H Wright
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina, USA
| |
Collapse
|
33
|
Phillips GS, Freret ME, Friedman DN, Trelles S, Kukoyi O, Freites-Martinez A, Unger RH, Disa JJ, Wexler LH, Tinkle CL, Mechalakos JG, Dusza SW, Beal K, Wolden SL, Lacouture ME. Assessment and Treatment Outcomes of Persistent Radiation-Induced Alopecia in Patients With Cancer. JAMA Dermatol 2021; 156:963-972. [PMID: 32756880 DOI: 10.1001/jamadermatol.2020.2127] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance Persistent radiation-induced alopecia (pRIA) and its management have not been systematically described. Objective To characterize pRIA in patients with primary central nervous system (CNS) tumors or head and neck sarcoma. Design, Setting, and Participants A retrospective cohort study of patients from January 1, 2011, to January 30, 2019, was conducted at 2 large tertiary care hospitals and comprehensive cancer centers. Seventy-one children and adults diagnosed with primary CNS tumors or head and neck sarcomas were evaluated for pRIA. Main Outcomes and Measures The clinical and trichoscopic features, scalp radiation dose-response relationship, and response to topical minoxidil were assessed using standardized clinical photographs of the scalp, trichoscopic images, and radiotherapy treatment plans. Results Of the 71 patients included (median [range] age, 27 [4-75] years; 51 female [72%]), 64 (90%) had a CNS tumor and 7 (10%) had head and neck sarcoma. Alopecia severity was grade 1 in 40 of 70 patients (56%), with localized (29 of 54 [54%]), diffuse (13 of 54 [24%]), or mixed (12 of 54 [22%]) patterns. The median (range) estimated scalp radiation dose was 39.6 (15.1-50.0) Gy; higher dose (odds ratio [OR], 1.15; 95% CI, 1.04-1.28) and proton irradiation (OR, 5.7; 95% CI, 1.05-30.8) were associated with greater alopecia severity (P < .001), and the dose at which 50% of patients were estimated to have severe (grade 2) alopecia was 36.1 Gy (95% CI, 33.7-39.6 Gy). Predominant trichoscopic features included white patches (16 of 28 [57%]); in 15 patients, hair-shaft caliber negatively correlated with scalp dose (correlation coefficient, -0.624; P = .01). The association between hair density and scalp radiation dose was not statistically significant (-0.381; P = .16). Twenty-eight of 34 patients (82%) responded to topical minoxidil, 5% (median follow-up, 61 [interquartile range, 21-105] weeks); 4 of 25 (16%) topical minoxidil recipients with clinical images improved in severity grade. Two patients responded to hair transplantation and 1 patient responded to plastic surgical reconstruction. Conclusions and Relevance Persistent radiation-induced alopecia among patients with primary CNS tumors or head and neck sarcomas represents a dose-dependent phenomenon that has distinctive clinical and trichoscopic features. The findings of this study suggest that topical minoxidil and procedural interventions may have benefit in the treatment of pRIA.
Collapse
Affiliation(s)
- Gregory S Phillips
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Morgan E Freret
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Sabrina Trelles
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Oluwaseun Kukoyi
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Azael Freites-Martinez
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Dermatology Service, Hospital Ruber Juan Bravo and Universidad Europea, Madrid, Spain
| | - Robin H Unger
- Department of Dermatology, Mount Sinai Medical Center, New York, New York
| | - Joseph J Disa
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Leonard H Wexler
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christopher L Tinkle
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - James G Mechalakos
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Stephen W Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kathryn Beal
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Suzanne L Wolden
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
34
|
Lacouture ME, Sibaud V, Gerber PA, van den Hurk C, Fernández-Peñas P, Santini D, Jahn F, Jordan K. Prevention and management of dermatological toxicities related to anticancer agents: ESMO Clinical Practice Guidelines ☆. Ann Oncol 2021; 32:157-170. [PMID: 33248228 DOI: 10.1016/j.annonc.2020.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- M E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - V Sibaud
- Department of Oncodermatology, Claudius Regaud Institute, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - P A Gerber
- Department of Dermatology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - C van den Hurk
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
| | - P Fernández-Peñas
- Department of Dermatology, The University of Sydney, Westmead Hospital, Sydney, Australia
| | - D Santini
- Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy; Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy
| | - F Jahn
- Department of Internal Medicine IV, Hematology, Oncology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - K Jordan
- Department of Medicine V, Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
35
|
Desai K, Almeida B, Miteva M. Understanding Hormonal Therapies: Overview for the Dermatologist Focused on Hair. Dermatology 2021; 237:786-791. [PMID: 33465769 DOI: 10.1159/000512888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/08/2020] [Indexed: 11/19/2022] Open
Abstract
Hormones have an intimate relationship with hair growth. Hormonal replacement therapy is used to treat menopausal symptoms and to provide protection from chronic diseases for which postmenopausal women may be at risk. Additionally, hormonal therapies are prescribed for contraception and treatment of acne. Considering the widespread use of such therapies, there is a demand for further understanding of their implications in hair disorders. This article reviews the specific properties of current estrogen- and progesterone-containing hormonal treatments and their implications for the patient with hair loss. The complexity of the task comes from the paucity of data and discrepancy in the literature on the effect of the specific hormonal-receptor activities.
Collapse
Affiliation(s)
- Karishma Desai
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA,
| | | | - Mariya Miteva
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|
36
|
Using the Common Terminology Criteria for Adverse Events (CTCAE – Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2019.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
37
|
Schielein MC, Tizek L, Ziehfreund S, Sommer R, Biedermann T, Zink A. Stigmatisierung durch Haarausfall – eine systematische Literaturübersicht. J Dtsch Dermatol Ges 2020; 18:1357-1369. [PMID: 33373136 DOI: 10.1111/ddg.14234_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 04/07/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Maximilian Christian Schielein
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - Linda Tizek
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - Stefanie Ziehfreund
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - Rachel Sommer
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - Alexander Zink
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| |
Collapse
|
38
|
Donahue S, Santos Fulgencio G. PI3K Inhibitors and Adverse Events: Optimizing Patient Care for the Treatment of Advanced Breast Cancer. Clin J Oncol Nurs 2020; 24:673-680. [PMID: 33216054 DOI: 10.1188/20.cjon.673-680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Excessive activation of the PI3K pathway has been associated with malignant transformation and resistance to treatment in various cancer types. Various PI3K inhibitors have been evaluated in phase 3 clinical trials; however, most have been associated with modest clinical improvement and poor tolerability. The safety profile of PI3K inhibitors poses new challenges in treatment monitoring and management of common adverse events (AEs). OBJECTIVES The purpose of this article is to provide an overview of AEs associated with PI3K inhibitors, with a focus on alpelisib, as well as guidance on the prevention and management of AEs. METHODS The literature and results from phase 3 trials evaluating the efficacy and safety of endocrine therapy plus PI3K inhibitors in patients with advanced breast cancer were reviewed. FINDINGS AEs associated with PI3K inhibitors include hyperglycemia, diarrhea, nausea, rash, and decreased appetite. Prevention strategies are recommended to avoid the development or decrease the severity of these AEs. Patient education and multidisciplinary care are necessary for the optimal care of these patients.
Collapse
Affiliation(s)
- Sarah Donahue
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center
| | | |
Collapse
|
39
|
Dell’Acqua G, Richards A, Thornton MJ. The Potential Role of Nutraceuticals as an Adjuvant in Breast Cancer Patients to Prevent Hair Loss Induced by Endocrine Therapy. Nutrients 2020; 12:nu12113537. [PMID: 33217935 PMCID: PMC7698784 DOI: 10.3390/nu12113537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 12/21/2022] Open
Abstract
Nutraceuticals, natural dietary and botanical supplements offering health benefits, provide a basis for complementary and alternative medicine (CAM). Use of CAM by healthy individuals and patients with medical conditions is rapidly increasing. For the majority of breast cancer patients, treatment plans involve 5–10 yrs of endocrine therapy, but hair loss/thinning is a common side effect. Many women consider this significant, severely impacting on quality of life, even leading to non-compliance of therapy. Therefore, nutraceuticals that stimulate/maintain hair growth can be proposed. Although nutraceuticals are often available without prescription and taken at the discretion of patients, physicians can be reluctant to recommend them, even as adjuvants, since potential interactions with endocrine therapy have not been fully elucidated. It is, therefore, important to understand the modus operandi of ingredients to be confident that their use will not interfere/interact with therapy. The aim is to improve clinical/healthcare outcomes by combining specific nutraceuticals with conventional care whilst avoiding detrimental interactions. This review presents the current understanding of nutraceuticals beneficial to hair wellness and outcomes concerning efficacy/safety in breast cancer patients. We will focus on describing endocrine therapy and the role of estrogens in cancer and hair growth before evaluating the effects of natural ingredients on breast cancer and hair growth.
Collapse
Affiliation(s)
| | | | - M. Julie Thornton
- Centre for Skin Sciences, University of Bradford, Bradford BD17 7DF, UK
- Correspondence:
| |
Collapse
|
40
|
Kukkar D, Kukkar P, Kumar V, Hong J, Kim KH, Deep A. Recent advances in nanoscale materials for antibody-based cancer theranostics. Biosens Bioelectron 2020; 173:112787. [PMID: 33190049 DOI: 10.1016/j.bios.2020.112787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/08/2020] [Accepted: 10/30/2020] [Indexed: 02/07/2023]
Abstract
The quest for advanced management tools or options of various cancers has been on the rise to efficiently reduce their risks of mortality without the demerits of conventional treatments (e.g., undesirable side effects of the medications on non-target tissues, non-targeted distribution, slow clearance of the administered drugs, and the development of drug resistance over the duration of therapy). In this context, nanomaterials-antibody conjugates can offer numerous advantages in the development of cancer theranostics over conventional delivery systems (e.g., highly specific and enhanced biodistribution of the drug in targeted tissues, prolonged systemic circulation, low toxicity, and minimally invasive molecular imaging). This review comprehensively discusses and evaluates recent advances in the application of nanomaterial-antibody bioconjugates for cancer theranostics for the further advancement in the control of diverse cancerous diseases. Further, discussion is expanded to cover the various challenges and limitations associated with the design and development of nanomaterial-antibody conjugates applicable towards better management of cancer.
Collapse
Affiliation(s)
- Deepak Kukkar
- Department of Nanotechnology, Sri Guru Granth Sahib World University, Fatehgarh Sahib, Punjab, 140406, India
| | - Preeti Kukkar
- Department of Chemistry, Mata Gujri College, Fatehgarh Sahib, Punjab, 140406, India
| | - Vanish Kumar
- National Agri-Food Biotechnology Institute (NABI), S.A.S. Nagar, Punjab, 140306, India
| | - Jongki Hong
- College of Pharmacy, Kyung Hee University, 26 Kyungheedae-ro, Seoul, 02447, Republic of Korea
| | - Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, Seoul, 04763 Republic of Korea.
| | - Akash Deep
- Central Scientific Instruments Organization (CSIR-CSIO), Sector 30 C, Chandigarh, 160030, India.
| |
Collapse
|
41
|
Perper M, Herskovitz I, Tosti A. Aromatase inhibitor-induced hair loss in two adolescents. Pediatr Dermatol 2020; 37:1125-1127. [PMID: 32869880 DOI: 10.1111/pde.14339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/20/2020] [Accepted: 08/04/2020] [Indexed: 11/28/2022]
Abstract
Hair loss and thinning are possible complications in those undergoing endocrine therapies with aromatase inhibitors. Alopecia in pediatric patients undergoing endocrine therapy has not been previously reported. We describe two adolescents, 14 and 16 years of age, who developed androgenetic alopecia following treatment with anastrozole for idiopathic short stature. Accordingly, the possible adverse event of alopecia should be considered in the pediatric population undergoing treatment with aromatase inhibitors.
Collapse
Affiliation(s)
- Marina Perper
- Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, Miami, Florida, USA
| | - Ingrid Herskovitz
- Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, Miami, Florida, USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, Miami, Florida, USA
| |
Collapse
|
42
|
Segal-Engelchin D, Shvarts S. Does Severity of Hair Loss Matter? Factors Associated with Mental Health Outcomes in Women Irradiated for Tinea Capitis in Childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207388. [PMID: 33050469 PMCID: PMC7601621 DOI: 10.3390/ijerph17207388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 12/04/2022]
Abstract
Hair loss resulting from childhood irradiation for tinea capitis has been linked to mental health effects in women. However, the association of hair loss severity with mental health in this population is unknown. To address this gap, this study examined the association between hair loss severity and mental health outcomes in women irradiated for tinea capitis in childhood as well as the factors that contribute to these outcomes. Medical records, held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims, were retrospectively reviewed for 2509 women who received compensation for full or partial alopecia resulting from irradiation for tinea capitis. Mental health outcomes were determined by the number of mental health conditions reported. The results show that among women with more hair loss, risk was increased for a range of mental health problems, especially social anxiety (RR 2.44, 95% CI 2.09–2.87). Hair loss severity emerged as a significant predictor of mental health, adding to the effects of other predictors such as family, social and physical health problems (β = 0.13, 95% CI 0.27, 0.56). The effects of hair loss severity on mental health outcomes were mediated by women’s negative social experiences (indirect = 0.72, 95% bias-corrected confidence interval, 0.53–1.08). Healthcare professionals supporting women with hair loss after irradiation for childhood tinea capitis should be alert to a history of severe levels of hair loss.
Collapse
Affiliation(s)
- Dorit Segal-Engelchin
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
- Correspondence:
| | - Shifra Shvarts
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel;
| |
Collapse
|
43
|
Schielein MC, Tizek L, Ziehfreund S, Sommer R, Biedermann T, Zink A. Stigmatization caused by hair loss - a systematic literature review. J Dtsch Dermatol Ges 2020; 18:1357-1368. [PMID: 33015951 DOI: 10.1111/ddg.14234] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 04/07/2020] [Indexed: 11/28/2022]
Abstract
Hair loss is a symptom that can cause stigmatization and severe impairment of quality of life. The aim of this systematic review was to evaluate the literature on stigmatization of hair loss. Using predefined MeSH terms and keywords, a systematic search was performed in the databases MEDLINE (PubMed), EMBASE, PsycINFO and PsycNET. No time restriction was chosen (last update: May 07, 2019; PROSPERO registration number: CRD42019122966). A total of 98 studies were identified, of which eleven were selected for inclusion in this work. The Hairdex, a questionnaire on disease-specific quality of life, was the most frequently used instrument for the quantitative assessment of stigma. The studies were highly heterogeneous and values for stigmatization of androgenetic alopecia varied widely. However, regardless of the pathogenesis, patients with hair loss often suffer from stigmatization which limits their quality of life. Stigmatization of people with visible skin lesions has often been neglected in clinical practice and in daily contact with affected individuals. Studies that specifically address the stigma of hair loss are rare. Further studies are needed to achieve comparability within pathogeneses as well as with other visible dermatoses in order to better understand the enormous psychosocial burden of hair loss.
Collapse
Affiliation(s)
| | - Linda Tizek
- Department of Dermatology and Allergology, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergology, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Rachel Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergology, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergology, Faculty of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
44
|
Thompson CT, Kolivras A. Alopecia areata-like pattern: A new unifying concept. J Cutan Pathol 2020; 48:351-355. [PMID: 32894601 DOI: 10.1111/cup.13864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/28/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Curtis T Thompson
- CTA Pathology, Portland, Oregon, USA.,Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, USA.,Department of Pathology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Athanassios Kolivras
- Département inter-hospitalier de Dermatologie, Saint-Pierre, Brugmann and HUDERF University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
45
|
Freites-Martinez A, Santana N, Arias-Santiago S, Viera A. Using the Common Terminology Criteria for Adverse Events (CTCAE - Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:90-92. [PMID: 32891586 DOI: 10.1016/j.ad.2019.05.009] [Citation(s) in RCA: 255] [Impact Index Per Article: 63.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 02/06/2023] Open
Affiliation(s)
- A Freites-Martinez
- Servicio de Dermatología, Hospital Ruber Juan Bravo y Universidad Europea, Madrid, España.
| | - N Santana
- Servicio de Dermatología, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Gran Canaria, España
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - A Viera
- Canarias dermatológica, Las Palmas de Gran Canaria, Gran Canaria, España
| |
Collapse
|
46
|
Suh HJ, Flórez Á, Sacristán V, Rodríguez Martinez Á, Fernández F, Vilanova-Trillo L, Constenla M, Pereiro M. Cutaneous adverse events in patients receiving anticancer therapy in a tertiary hospital setting: the old and the new. Int J Dermatol 2020; 60:208-216. [PMID: 33502780 DOI: 10.1111/ijd.15081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/11/2020] [Accepted: 07/01/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Targeted therapies and immunotherapies are increasingly prescribed, but classic chemotherapy agents are still highly used in cancer treatment. Both therapies, the old and the new, are associated with cutaneous adverse events (CAEs) that can cause treatment interruptions or reduce the quality of life of patients. METHODS An observational, cross-sectional, single-center study that included consecutive cancer patients presenting CAEs. The main objective was to describe CAEs derived from antineoplastic drugs. Secondary objectives were to determine the number and severity of CAEs and if there were differences regarding CAEs between conventional chemotherapeutics and targeted therapies. RESULTS A total of 114 patients were included with a total number of 177 CAEs. Of the 114 patients, 64 presented a single CAE, 37 patients had two CAEs, and 13 patients presented three CAEs. The most frequent CAEs were pruritus, xerosis, palmar-plantar erythrodysesthesia (PPE), and alopecia. The majority of CAEs were mild (63.2%), followed by moderate (29.9%) and severe (6.7%) CAEs. Of the 114 patients, 103 (90.3%) received topical agents and 11 (9.7%) required systemic treatment for the management of CAEs. Prophylactic treatment for CAE was delivered to only 4/114 (3.5%) patients. No significant differences were found in the number or severity of CAEs between conventional chemotherapy and targeted therapy. CONCLUSIONS Close collaboration between oncologists and dermatologists is essential to start preventive measures on time, enhance patient education, and avoid unnecessary dose reductions or treatment interruptions. The multidisciplinary approach can offer better management of skin toxicities.
Collapse
Affiliation(s)
- Hae-Jin Suh
- Dermatology Department, Pontevedra University Hospital, Pontevedra, Spain
| | - Ángeles Flórez
- Dermatology Department, Pontevedra University Hospital, Pontevedra, Spain
| | - Víctor Sacristán
- Medical Oncology Department, A Coruña University Hospital, A Coruña, Spain
| | | | | | | | - Manuel Constenla
- Medical Oncology Department, Pontevedra University Hospital, Pontevedra, Spain
| | - Manuel Pereiro
- Surgical Medical Specialties Department, Dermatology Section, Santiago de Compostela University, Santiago de Compostela, Spain
| |
Collapse
|
47
|
Abstract
Drug-induced changes of hair and nails have been observed with a variety of different pharmaceutical agents, both topical and systemic. These compounds or their metabolites may interfere with hair cycling and texture, nail matrix, nail bed, nail folds, and microvasculature. Phototoxic reactions may also occur. Before initiating treatment, physicians and patients should be aware of possible adverse events to hair and nails and should be aware of the preventive measures, if available, as quality of life can be reduced, and adherence and compliance to treatment may be impaired.
Collapse
Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany.
| | | |
Collapse
|
48
|
Eiger D, Wagner M, Pondé NF, Nogueira MS, Buisseret L, de Azambuja E. The impact of cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) on the incidence of alopecia in patients with metastatic breast cancer (BC). Acta Oncol 2020; 59:723-725. [PMID: 32167397 DOI: 10.1080/0284186x.2020.1738547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Daniel Eiger
- Institut Jules Bordet and L’Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | | | | | | | - Laurence Buisseret
- Institut Jules Bordet and L’Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Evandro de Azambuja
- Institut Jules Bordet and L’Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| |
Collapse
|
49
|
Ferreira MN, Ramseier JY, Leventhal JS. Dermatologic conditions in women receiving systemic cancer therapy. Int J Womens Dermatol 2019; 5:285-307. [PMID: 31909148 PMCID: PMC6938835 DOI: 10.1016/j.ijwd.2019.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/12/2019] [Accepted: 10/13/2019] [Indexed: 12/24/2022] Open
Abstract
As advances in cancer therapies have improved cancer-related survival, novel therapeutics have also introduced a variety of dermatologic toxicities, and an increased number of patients are living with these sequalae. Women with cancer in particular experience a spectrum of dermatologic conditions that affect their skin, hair, nail, and mucosal surfaces. Studies have shown that these toxic effects can significantly affect quality of life and alter a woman's self-image, cultural identity, femininity, sexuality, and mental health. In severe instances, dermatologic toxicities may even disrupt cancer therapy and can therefore affect overall survival and treatment response. In this article, we review the dermatologic adverse effects from traditional chemotherapy, targeted therapy, immune checkpoint inhibitors, and endocrine therapy that disproportionately affect women. The timely diagnosis and management of these dermatologic conditions is crucial in the multidisciplinary care of women with cancer.
Collapse
|
50
|
Varvaresou A, Iakovou K, Mellou F, Myrogiannis D, Papageorgiou S. Targeted therapy in oncology patients and skin: Pharmaceutical and dermocosmetic management. J Cosmet Dermatol 2019; 19:782-788. [PMID: 31769600 DOI: 10.1111/jocd.13211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 09/23/2019] [Accepted: 10/15/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Numerous oncology patients who receive targeted therapy suffer from the skin adverse effects induced. Novel agents, that is tyrosine kinase inhibitors and RAS-RAF-MEK-ERK pathway, have given good results in patient survival while decreasing the systemic toxicities in comparison to conventional cytotoxic chemotherapy, but are also related to skin adverse effects. AIMS In this article, we highlighted the importance of specific pharmaceutical and dermocosmetic management of the untoward events of targeted therapy. CONCLUSION The combination of Oncodermatology, Psychodermatology, Cosmetic Dermatology, Cosmetic Science, Dermatopharmacology and Aesthetic Science can offer a lot for the prevention or early relief of the cutaneous adverse effects in oncology patients receiving targeted therapy.
Collapse
Affiliation(s)
- Athanasia Varvaresou
- Research Laboratory of Chemisty, Biochemistry and Cosmetic Science, Department of Biomedical Sciences, University of West Attica, Egaleo, Greece
| | | | - Fotini Mellou
- Research Laboratory of Chemisty, Biochemistry and Cosmetic Science, Department of Biomedical Sciences, University of West Attica, Egaleo, Greece
| | | | - Spyros Papageorgiou
- Research Laboratory of Chemisty, Biochemistry and Cosmetic Science, Department of Biomedical Sciences, University of West Attica, Egaleo, Greece
| |
Collapse
|