Top Line: Can a topical carbon nanomaterial reduce radiation dermatitis in head and neck cancer patients?
The Study: Fullerene is a carbon nanomaterial with a hollow spherical cage structure that could serve as a protective barrier for epidermal stem cells. The idea is that radiation-induced water radiolysis generates a burst of reactive oxygen species that damages basal epidermal stem cells, and fullerene directly neutralizes those free radicals. This phase II double-blind trial randomized 132 patients receiving concurrent chemoradiation for head and neck cancer to topical fullerene cream (500 ppm) or trolamine (Biafine), applied three times daily starting 3 days before RT and continuing 14 days after completion. The primary endpoint of grade 2+ dermatitis was significantly less with fullerene cream (34.8% v 83.3%), and grade 3 dermatitis was slashed from 40.9% to 6.1%. Among those who did develop dermatitis, duration was halved with fullerene cream (14 v 28 days). An exploratory microbiome analysis suggested fullerene preserved skin microbial diversity and enriched short-chain fatty acid–producing taxa associated with barrier integrity. Safety was comparable between arms. Important caveats are that no stratification was used for randomization and the rate of grade 2+ toxicity was relatively high in the control arm.
TBL: This trial demonstrated impressive reductions in acute radiation dermatitis in head and neck cancer patients using a fullerene-based cream that is thought to neutralize reactive oxygen species at the skin surface that may damage epidermal stem cells. | Liu, J Clin Oncol 2026
The Study: Fullerene is a carbon nanomaterial with a hollow spherical cage structure that could serve as a protective barrier for epidermal stem cells. The idea is that radiation-induced water radiolysis generates a burst of reactive oxygen species that damages basal epidermal stem cells, and fullerene directly neutralizes those free radicals. This phase II double-blind trial randomized 132 patients receiving concurrent chemoradiation for head and neck cancer to topical fullerene cream (500 ppm) or trolamine (Biafine), applied three times daily starting 3 days before RT and continuing 14 days after completion. The primary endpoint of grade 2+ dermatitis was significantly less with fullerene cream (34.8% v 83.3%), and grade 3 dermatitis was slashed from 40.9% to 6.1%. Among those who did develop dermatitis, duration was halved with fullerene cream (14 v 28 days). An exploratory microbiome analysis suggested fullerene preserved skin microbial diversity and enriched short-chain fatty acid–producing taxa associated with barrier integrity. Safety was comparable between arms. Important caveats are that no stratification was used for randomization and the rate of grade 2+ toxicity was relatively high in the control arm.
TBL: This trial demonstrated impressive reductions in acute radiation dermatitis in head and neck cancer patients using a fullerene-based cream that is thought to neutralize reactive oxygen species at the skin surface that may damage epidermal stem cells. | Liu, J Clin Oncol 2026