TOPLINE:

In a pilot study of breast cancer survivors with endocrine-induced alopecia (EIA) or persistent chemotherapy-induced alopecia (pCIA), platelet-rich plasma (PRP) treatment increased hair density, with improvements observed on both treated and untreated scalp areas, likely due to PRP diffusion.

METHODOLOGY:

• Researchers conducted a single-blinded, randomized, controlled split‑scalp pilot study of 27 female breast cancer survivors (mean age, 57 years), including 15 with EIA and 12 with pCIA, at Memorial Sloan Kettering Cancer Center, between 2020 and 2022.
• Patients had Ludwig scale 1-3 alopecia and had failed prior therapy with topical minoxidil 5%, oral minoxidil, and/or spironolactone for 3 months or more; those with EIA stayed on the same endocrine therapy dosage throughout the study.
• Participants received PRP injections (15-20 mL per session) on one side of their scalp once monthly for three sessions, the other side served as the untreated control.
• A blinded investigator assessed the primary outcome (photographic global assessment scale [GAS] at week 12). Secondary outcomes included hair-related trichoscopic metrics (hair density, terminal/vellus counts, shaft diameter, intrafollicular distance), quality of life, circulating tumor cell assay, and adverse events.

TAKEAWAY:

• GAS scores improved significantly from baseline on both PRP‑treated and untreated sides at 12 weeks (mean difference [MD], +1.2 each; P < .001) and 24 weeks (MD, +1.5 vs +1.3; P < .001) but were not significantly different between the two sides.
• Hair density increased significantly from baseline on both treated and untreated sides (MD, +21 vs +16 hairs/cm²; P < .05), with no significant difference between the two sides (P > .05).
• No significant differences in any trichoscopic metrics, including hair density, hair shaft diameter, and intrafollicular distance, were observed over 24 weeks. Patient‑reported quality‑of‑life scores decreased from baseline to weeks 12 and 24 weeks (mean, 41.1 to 39.4 and 39.8 to 38.3, respectively), but the changes were not significant.
• All patients experienced postinjection scalp pain, which was mostly mild-to-moderate, though 9% reported severe pain. Circulating tumor cells were detected in PRP samples from two of 12 tested patients, but no tumor seeding or adverse cancer-related events occurred during follow-up.

IN PRACTICE:

“This study is the first to show PRP’s safety, feasibility, and potential use for EIA and pCIA patients, with results of efficacy confounded by the split-scalp study design,” the authors wrote, noting that other studies in different types of alopecia have reported PRP diffusion resulting in treatment effects in the placebo area. “Further research involving trials with whole-scalp placebo controls is warranted to further elucidate PRP’s potential in pCIA and EIA patients,” 

SOURCE:

This study was led by Anthony Rossi, MD, dermatology service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, and was published online in Dermatologic Surgery.

LIMITATIONS:

This study was limited by its small sample size, split-scalp study design, mild grade of alopecia among participants, and the generalizability was restricted to patients with pCIA and EIA. The volume of PRP used exceeded common clinical practice of 5-9 mL.

DISCLOSURES:

This study received support from RegenLab, National Cancer Institute/National Institutes of Health grant, the Society of MSK, and research support from the German Research Foundation. Several authors reported receiving funding, grants, advisory fees, consulting fees from the Society of MSK and multiple pharmaceutical companies, including Recordati Rare Diseases, AstraZeneca, and Pierre Fabre Pharma. Detailed disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.