206P - Incidence of permanent alopecia following adjuvant chemotherapy in women with early stage breast cancer.

Date 11 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Breast Cancer, Early Stage
Complications of Treatment
Breast Cancer
Presenter John Crown
Citation Annals of Oncology (2017) 28 (suppl_5): v43-v67. 10.1093/annonc/mdx362
Authors J. Crown1, J. Walshe2, D. Fennelly3, J. Long1, S. Cairney2, D. McDonnell1, J. Ballot2, D. Wildes2, E. Sills1, G. Gullo3
  • 1Medical Oncology, St Vincents University Hospital, 4 - Dublin/IE
  • 2Medical Onoclogy, St Vincents University Hospital, 4 - Dublin/IE
  • 3Medical Oncology Department, St Vincents University Hospital, 4 - Dublin/IE

Abstract

Background

Alopecia is one of the most distressing toxicities of adjuvant chemotherapy for patients with breast cancer. Historically, oncologists have reassured patients (pts) that chemotherapy-induced alopecia is temporary, and followed by full hair recovery. More recently there have been troubling reports of permanent alopecia following adjuvant taxanes (Tax). We studied the incidence of long-term hair loss in patients treated on adjuvant trials in our institution. Patients who were enrolled on clinical trials involving Tax (D-Docetaxel, P-Paclitaxel) and/or Anthracyclines (A) were included.

Methods

We conducted a telephone interview survey of pts who had completed adjuvant or neo adjuvant A and/or T chemotherapy on clinical trials more than one year before. Ongoing alopecia was graded as 0 (full hair recovery), 1 (mild hair loss) or 2(severe/total). The study was approved by the hospital audit committee.

Results

We studied 295 pts who has been treated on 12 studies. Drug exposure: D-260 pts (D nonA-185, D+A-75); A-nonTax-12 pts; A+P 23 pts. The overall incidence of alopecia was 15% (11% grade 1 and 4% grade 2). For all D the incidence was 15% (12% Grade 1 and 3% Grade 2). For D+A-24% (19% Grade 1 and 5% Grade 2). For D non A the incidence was 13% (8% grade 1 and 5% grade 2). For A non T 8% (Grade 2-8%). For PA-13% (4% grade 1 and 9% grade 2). For patients receiving D non-A regimens, there were two levels of D exposure, 300mg/m2 (90 pts) or 450 mg/m 2 (95 pts). The incidence of alopecia was significantly D dose dependent: D300- 7% (all grade 1) and D 450-19% (14% grade 1, 5% grade 2) (p=.02 chi2) . Among the higher dose D group, the companion drug choices carboplatin for HER2 positive, (55 pts) or cyclophosphamide (40 pts) were associated with similar incidences of permanent alopecia (22% v 16%).

Conclusions

Permanent alopecia is a common complication of adjuvant chemotherapy. The risk appears to be highest in regimens which contain A and D, but it is also seen in D non-A, AP and in A non-Tax. For patients receiving D non A, the risk is dose-dependent. Our set contains few P pts, and no pts undergoing low dose weekly P. Oncologists should warn all patients undergoing adjuvant therapy of the risk of permanent alopecia.

Clinical trial identification

Legal entity responsible for the study

John Crown

Funding

None

Disclosure

All authors have declared no conflicts of interest.