Is my significant hair loss related to the Avastin (bevacizumab) chemotherapy injections I'm receiving?

From the Guidelines

Your significant hair loss is likely related to your Avastin (bevacizumab) chemotherapy injections, although the evidence suggests that Avastin alone typically causes less hair loss than traditional chemotherapy drugs. According to the most recent study 1, the NCCN panel recommends considering scalp cooling to reduce the incidence of chemotherapy-induced alopecia for patients receiving chemotherapy.

Key Points to Consider

• Hair loss from Avastin usually begins 2-3 weeks after starting treatment and varies in severity from person to person.
• The mechanism involves the drug's interference with blood vessel growth, which can affect hair follicles and their normal growth cycle.
• This hair loss is usually temporary, and regrowth typically begins within 3-6 months after completing treatment.
• During treatment, you might consider gentle hair care practices like using mild shampoos, avoiding heat styling, and wearing a soft cap or scarf to protect your scalp.
• If the hair loss is severe or distressing, discuss it with your oncologist, as they may recommend supportive measures or adjust your treatment if appropriate while still maintaining effective cancer therapy.

Management and Prevention

• The NCCN panel finds no compelling evidence that combination chemotherapy is superior to sequential single agents, and thus, sequential monotherapy is preferred 1.
• Adverse effects, including hair loss, may require dose reduction and cessation of chemotherapy prior to disease progression.
• A more recent study showed that intermittent first-line treatment with paclitaxel plus bevacizumab was not inferior to continuous treatment in terms of overall survival and progression-free survival 1.

Next Steps

• Discuss your hair loss with your oncologist to determine the best course of action and potential supportive measures.
• Consider gentle hair care practices and scalp cooling to reduce the incidence of chemotherapy-induced alopecia.
• Continue to follow up with your oncologist to monitor your condition and adjust your treatment plan as needed.

From the Research

Chemotherapy-Induced Hair Loss

• Chemotherapy-induced alopecia (CIA) is a common side effect of chemotherapy, affecting approximately 65% of patients 2, 3.
• The condition is often ranked as one of the most distressing adverse effects of chemotherapy, with 47% of female patients considering hair loss to be the most traumatic aspect of chemotherapy 3.
• Chemotherapy causes substantial thinning or loss of hair due to damage to rapidly proliferating healthy cells, including hair follicle keratinocytes 2.

Relationship between Avastin (Bevacizumab) and Hair Loss

• While there is no direct evidence linking Avastin (bevacizumab) to hair loss, chemotherapy in general is known to cause hair loss 2, 3, 4, 5, 6.
• It is likely that the hair loss experienced by the patient is related to the chemotherapy injections, including Avastin (bevacizumab), as part of their cancer treatment.

Prevention and Treatment of Chemotherapy-Induced Alopecia

• Currently, scalp cooling is the only FDA-cleared method to prevent CIA, but its use is limited due to high costs and other factors 2.
• Topical minoxidil has been shown to reduce the severity or shorten the duration of hair loss, but it does not prevent hair loss 3, 4.
• Other interventions, such as photobiomodulation therapy (PBMT) and platelet-rich plasma (PRP) injections, are being tested to stimulate hair regrowth after hair loss 2.