Around 50,000 women are diagnosed with breast cancer in the UK each year. The best drug that they can take to treat it, tamoxifen, will make 40% of them so sick each and every day that many struggle to even to get the vital medicine their body needs.
Ask Angelina Jolie. When she discovered that she carried the defective BRCA1 breast cancer gene, rather than a lifetime of tamoxifen treatment, she chose a double mastectomy.
For those not willing to make that choice, however, there is a wearable in development to help the medicine go down.
With World Cancer Day on 4 February, we decided to find out more about it.
The real Wonderbra
Masters student Sarah da Costa, on the Central Saint Martins Material Futures design-meets-science-and-technology course, has invented a bra that can deliver tamoxifen through the user’s skin to exactly where it’s needed.
The drug is ‘microencapsulated’ within tiny bubbles in a biopolymer material which itself is part of the garment’s fabric. These bubbles gradually burst through moisture and friction as the day wears on making for a slow and steady release into the user’s body, and, because it’s a nano drug it can easily diffuse through a silk mesh and into the skin.
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“Rather than a patch, which is acute and more for pain, this is a gentle and sustained delivery using best practice drugs,” explains da Costa with a background knowledge from her previous career in pharmaceuticals.
Tamoxifen itself is derived from the Digitalis or Foxglove plant and is why da Costa has chosen to name the biopolymer the Foxleaf, at least while it’s a working title. The modular section is designed to last for one month before it needs replacing and is entirely biodegradable, plus there’s a plan to microencapsulate a dye as well so that the user knows when the drugs are spent.
“It’s a completely different way of thinking about the soft surfaces around us in terms of what we wear for eight hours each day; in this case, a bra.”
Saving millions of pounds, and millions of lives
The idea was partly inspired by the Asha headscarf which uses microencapsulation to deliver essential oils to women who’ve lost their hair after chemotherapy but this is the first time the technique will have been used for active drugs.
This gentler, more passive approach will not only help those who cannot stomach taking tamoxifen orally but will also improve compliance. According to a study at Aston University between between one-third and a half of all medicines prescribed for long-term conditions are not taken as recommended, and that’s estimated to cost the NHS around £100 million each year.
“I was thinking, ‘What can we do about all this pharmaceutical waste?’ and thought, ‘why can’t we apply microencapsulation for active drugs?’”
The idea fitted perfectly with da Costa’s Material Futures project brief - to use current biotechnology to prevent age-related disease - and what’s followed has been something of a perfect storm of expertise and inspiration.
“There was so much in the press about the 40% of women unable to tolerate this best practice drug and it was coming to the fore last year that girls with a family history of breast cancer would be able to take this gene marker test through saliva instead of blood. You can do it at your GPs.”
With a 18-25-year-old target group in mind - who have a staggering 90% chance of developing breast cancer if they carry one of these genes - da Costa set about holding focus groups to source the right styles and materials and even had input from designers at Agent Provocateur to make sure that this would be one wearable that these girls would definitely wear.
Four years to market
On the science side, she’s been working with the Biotechnology department at the University of Westminster and they’re now ready to begin pre-clinical trials with the road to market ending, hopefully, within the next four years.
“It’s been a real cross-collaboration,” she beams. “It’s the most challenging and most amazing thing I’ve ever done. I had a lot of support from the London College of Fashion, my tutors at Central Saint Martins and across the board from women who had friends and sisters and nieces who’d suffered from breast cancer. It’s a very emotive subject.”
A leap from the world of pharmaceuticals to a masters in craft and textiles might seem a strange one but both of da Costa’s parents were designers themselves, and, although she has not been affected by breast cancer personally, it was family tragedy that ultimately became the trigger for her change in life when her father passed on.
“He really loved his job,” she says. “And, at the time, I was chasing pharmaceutical targets and money and wasn’t really enjoying what I was doing. I did a conversation at Croydon where I redesigned paediatric hospital gowns in antimicrobial fibres with different surface patterns - XX with daisies for girls and XY with toy cars for boys.”
The plan beyond the Foxleaf Bra is to bring biopolymer drug delivery to different wearables for sufferers of different conditions. Underpants for men with prostate cancer and either pyjamas or bed sheets for those who need to take drugs for dementia are just two of the obvious directions that da Costa mentions.
“It’s really about designing optimistic futures. There will be lots of applications and site specific polymers. If we design something that’s desirable, that people want to wear, then you’re automatically increasing compliance and avoiding all those aggressive first pass side effects through the liver that you get with oral therapy, and that can only be a good thing.”
A very good thing indeed.