When your hair turns white it is usually a sign of old age, but in advanced melanoma patients taking a new type of cancer treatment, it may be a very good sign, researchers said on Saturday.
They said Bristol-Myers Squibb's ipilimumab and Pfizer's tremelimumab — two experimental drugs that aim to fight cancer by boosting the immune system — had the peculiar effect of turning some patients' hair completely white.
All of the patients whose hair turned white had a complete response to treatment, meaning their tumors were no longer visible on CT scans. That suggests white hair may be an early sign that the drugs will work against the deadly skin cancer.
"We start to see the depigmentation six months to one year after initiating therapy," said Dr. Anna Pavlick, director of the melanoma program at New York University's Langone Medical Center, who has treated 48 patients with ipilimumab or tremelimumab.
Both are engineered versions of human antibodies. They are designed to block CTLA-4, an immune system molecule that works by keeping the immune system in check.
"We have 17 out of those 48 patients that have either complete or partial response to the therapy, which is pretty damn good," said Pavlick, who is presenting her findings at the American Society of Clinical Oncology meeting in Chicago.
"We have nine of those patients who have complete depigmentation of their hair. Those nine patients have had complete response radiologically," she said.
Losing hair color is ‘a healing sign’
"I'm pretty confident to say if patients start to develop depigmentation after six to 12 months, they are going to have a durable response."
Pavlick said that when patients were asked about their hair turning white, their stories were all the same.
"It always starts in the eyebrows. It goes from the eyebrows to the crown of the hair, assuming they have hair there. If they don't, it usually starts with their sideburns," she said. "To me it's a healing sign."
Pavlick said it was unclear why patients who respond to the drugs so well lose all of the pigment in their hair. Her team is studying this in hopes of finding ways for more melanoma patients to benefit.
A separate study of Bristol-Myers drug ipilimumab released on Saturday found that more than 20 percent of patients with advanced melanoma were alive two years after getting the drug -- compared to the usual nine months.
After scores of failed melanoma drugs, Pavlick said she is thrilled to have a compound that helps at least some of her patients.
"I think we're taking a baby step. When you haven't even been able to crawl for 40 years, that baby step looks like a giant step," she said.