Researchers from France have reported that a 90 minute cold treatment of the hands can prevent Taxotere (docetaxel) nail and finger toxicities. The details of this report appeared in the July 1, 2005, issue of the Journal of Clinical Oncology .

Nail and skin toxicities are frequently observed in patients treated with Taxotere-containing regimens. These signs and symptoms are a usual response after treatment is discontinued but can be unpleasant. Cold temperatures have been found to decrease the toxicity of certain chemotherapy drugs by decreasing the blood flow. This approach has been used to prevent alopecia with the use of cold caps and the use of ice chips to prevent oral mucositis.

In this recent study, researchers evaluated a new product known as the Elasto-Gel frozen glove for the prevention of Taxotere-induced nail changes and skin toxicity. This glove is patented and contains glycerin, which has thermal properties allowing for hot or cold use. The gel-filled glove covers the hand to the wrist and separates the thumb from the rest of the hand. Before use the glove is refrigerated for at least 3 hours at -25 to -30 degrees.

The 45 patients included in the study received Taxotere either alone or as part of a combination chemotherapy regimen. Each patient wore the frozen glove for a total of 90 minutes on his or her right hand; the left hand was left untreated to serve as the control. Skin toxicity and nail changes were evaluated at each treatment cycle and were documented and photographed. The National Cancer Institute Toxicity Criteria was used to grade the skin reactions; grades ranged from 0 to 4 (4 being the worst cases of skin ulceration and irritation).

Results of the study found that, overall, nail and skin toxicity was significantly lower in the treated hand compared to the untreated hand. Nail changes of a 0 grade (least severe) occurred in 89 percent of the treated hands, whereas only 49 percent of the non-treated hands showed 0-grade changes. Grade 1 and 2 nail changes occurred in 11 percent of the treated hands, versus 51 percent for the untreated hands. The frozen glove also positively affected skin toxicity, with grade 0 toxicity occurring in 73 percent of hands treated with the frozen glove compared to 41 percent of the untreated hands. Grade 1-2 skin toxicity was also improved in the treated hands at a rate of 27 percent versus 59 percent. The average time for nail and skin toxicity to occur was not significantly different between the frozen glove and the untreated hand (106 versus 58 days for nail toxicity; 57 versus 58 days for skin toxicity). Only five patients discontinued treatment due to cold intolerance. Researchers concluded that the frozen glove significantly reduces skin and nail toxicity associated with Taxotere and offers a new option for providing supportive care and improving patient’s quality of life.

Comment: An Internet search found an Elsto-Gel Website but no description of or information on the availability of the glove in the United States. Presumably the same results could be achieved by immersion of the hands in ice water. However, this may be inconvenient for the relatively long time apparently needed to reduce the exposure of hands to Taxotere.

Reference: Scotte F, Tourani J, Banu G, et al. Multicenter study of a frozen glove to prevent docetaxel induced onycholysis and cutaneous toxicity of the hand. Journal of Clinical Oncology . 2005; 23: 4424-4429.