Transformation of Agro-Industrial By-Products into High-Value Animal-Derived Foods: Bioactive Compounds, Microbiome-Mediated Biotransformation, Metabolomic Traceability and Circular Valorization.

Localized breast cancer accounts for over 60,000 new cases yearly in France. Approximately one quarter of these patients require anthracycline- and taxane-based chemotherapy as part of their neoadjuvant or adjuvant treatment regimen (typically three to four cycles of epirubicin–cyclophosphamide [EC] followed by either three cycles of docetaxel or 9–12 weekly cycles of paclitaxel). These regimens are highly hair-loss inducing and cause chemotherapy-induced alopecia (CIA) in the vast majority of patients in the absence of preventive measures. CIA occurs in most of cases within the first two weeks after the first dose of chemotherapy. It is usually transient but persistent alopecia is reported in up to 10% of cases []. Hair regrowth usually begins 4–6 weeks after chemotherapy completion but may be delayed or of suboptimal quality, especially following anthracycline or taxane exposure []. For patients, hair loss is often perceived as a visible hallmark of cancer, and sometimes the only outward sign of illness. CIA is thus one of the most distressing chemotherapy-related adverse effects, with substantial psychosocial repercussions, including impaired body image and decreased psychosocial well-being and quality of life []. From the last decades, scalp hypothermia has been widely used to prevent and decrease CIA. Nowadays, scalp cooling can be achieved using either cold-cap systems, or the more recent scalp cooling machines: they are currently the only evidence-supported interventions [,]. Standard cold-cap systems consist in glycerin-based gel caps frozen and stored at temperature around −18°C to −25°C, applied directly to the scalp during a time overlapping chemotherapy administration. These caps allow generating surface temperatures around –15°C but have to be replaced every 30–45 minutes to maintain efficacy throughout the chemotherapy course. Automated scalp cooling systems (e.g., PAXMAN® PSCS 2) include a computer-controlled refrigeration unit that circulates coolant at –4°C through a fitted cap, maintaining continuous and stable temperature cooling scalp throughout chemotherapy infusion and post-infusion. These two modalities of scalp cooling for CIA prophylaxis are suitable for patients harbouring solid tumors with the exception of central nervous tumors, and contraindicated for patients with brain or scalp metastases, or with some hematological malignancies. Safety evaluations have shown no increased risk of scalp metastases with these techniques [–]. Mechanistically, these devices exert a compressive and cooling effect on the scalp, leading to vasoconstriction, which reduces local blood flow and thereby limits delivery of cytotoxic agents administered intravenously to hair follicles. Additionally, scalp cooling may reduce (i) mitotic activity in follicular keratinocytes, making them less susceptible to chemotherapy-induced damage, (ii) as well as intra-follicular metabolic rate []. Preservation of hair follicles may also result in faster and more homogeneous hair regrowth, an effect of particular interest in taxane-based regimens, which can impair regrowth quality [].