Abstract 4581
Background
Sensor-controlled scalp cooling (SCSC) has been found to be effective to prevent chemotherapy (Ctx)-induced alopecia (CIA). This retrospective study sought to obtain detailed information which clinical parameter is able to predict the success of SCSC in patients (pts) with primary (PBC) or recurrent/metastatic breast cancer (R/MBC) exposed to neoadjuvant (NACT), adjuvant (ACT), or palliative Ctx (PCT) using anthracyclines (A), taxanes (T), both given at different schedules (A+T/A→T, T→A) or none of them (non-A/non-T).
Methods
109 pts who underwent SCSC were included: NACT, 47 (54.6%); ACT, 40 (45.4%); PCT 22; dose-dense (dd) Ctx, 38 (44.2%); non-dd Ctx 48 (55.8%); premenopausal, 48 (55.8%); postmenopausal, 38 (44.2%). Ctx regimens were: A+T/A→T, 41 (37.6%), T→A, 23 (26.7%), T, 34 (31.2%), non-A/non-T, 11 (10.1%). 3 wks after the last Ctx cycle, CIA was quantified according to the Dean score (DS). Data were analyzed in regard to the SCSC completion rate, and the quality of hair preservation (success: DS 0-2, failure: DS 3-4). The following parameters were investigated in regard to the success of SCSC: menopausal status, pretreatment, setting of Ctx, Ctx schedule, Ctx regimen.
Results
Success rate was 67.9% with 47 pts (43.1%) experiencing complete (DS 0), and 27 (24.8%) showing partial response (DS 1-2). 30 pts (27.5%) stopped SCSC prematurely with CIA being the reason in 21 pts (19.3%). Effectiveness of SCSC did not differ for most analyzed subgroups. The relative risk (RR) to experience CIA was 1.18 (CI: 0.91-1.53, p=NS) for post- vs premenopausal pts, 1.27 (CI: 0.99-1.64, p=NS) for Ctx-naïve vs pretreated pts, 1.18 (CI: 0.89-1.56, p=NS) for dd Ctx vs non-dd Ctx, 1.42 (CI: 1.03-1.80, p = 0.05) for NACT/ACT vs PCT, and 1.42 (1.11-1.85, 0.012) for A-based Ctx vs non A-based Ctx. Success rates for A+T/A→T, T→A, T, and non-A/non-T were 48.8%, 73.9%, 79.4%, and 90.9% (p = 0.015).
Conclusions
SCSC could effectively prevent CIA in a real-world population of pts with PBC or R/MBC with all subgroups of pts benefiting. NACT/ACT and A-based Ctx are associated with lower success rates of SCSC. However, the effectiveness of SCSC associated with A-based Ctx can be as high providing that Ctx does not start with an anthracycline.
Clinical trial identification
Legal entity responsible for the study
Christian M. Kurbacher, Gynaecological Centre Bonn-Friedensplatz.
Funding
Has not received any funding,
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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