Immunotherapy Side Effects in Patients with Lung Cancer
What surprising side effect can immunotherapy cause in lung cancer patients?
a. vanishing fingerprints
b. compulsive gambling
c. hair repigmentation
d. blue urine
Answer: c
Immunotherapy might make one lung cancer patient’s gray hair turn black. The surprising side effect could even be explained away if it occurred in two patients. But imagine the shock the authors of a new study must have felt when shocks of gray hair turned dark on 13 of 52 lung cancer patients who took Keytruda, Opdivo, and Tecentriq [JAMA Dermatol. doi:10.1001/jamadermatol.2017.2106]. The medications also caused black patches to appear on the gray hair of another patient.
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All but 1 of the 14 patients who experienced hair repigmentation experienced better immune response to the therapies than the 38 patients whose hair color did not change. That means hair repigmentation may be a good response marker in patients receiving anti-PD1/anti–PD-L1 therapy for lung cancer, according to the researchers. Could immunotherapy also be the latest hair coloring solution for the graying generation? Not so fast. The drugs are associated with other more serious side effects that make them impractical for coloring coifs.
This is the first report of a previously undescribed side effect of checkpoint inhibitors in patients treated for lung cancer, according to Dr. June K. Robinson, a research professor of dermatology at Northwestern University School of Medicine, who was not involved in the study. She pointed out that hair and skin pigmentation are linked to immunity and said it was interesting that the phenomenon appeared to be more likely to occur in men, a finding that suggested hair repigmentation may be related to X-linked genes.
The way in which these drugs may restore original hair color is unknown and has only been observed in patients treated for lung cancer, said Dr. Robinson. She pointed out that immunotherapy given to patients with melanoma may cause skin cells to lose pigmentation and said further research is therefore needed to truly understand how the drugs alter hair color.
—Dan Cook
