Impact of chemotherapy sequence on the efficacy of scalp cooling devices for alopecia prevention.

e12034 Background: The use of scalp cooling devices (SCD) has been widely adopted for prevention against chemotherapy-induced alopecia (CIA). However, efficacy of SCD varies between different chemotherapy (CT) regimens. The aim of this study was to evaluate the effectiveness of SCD in breast cancer patients with different CT regimens treated in a tertiary cancer center in Monterrey, Mexico. Methods: All consecutive patients who used SCD were included. Data regarding treatment regimens and efficacy outcomes were prospectively collected. A descriptive analysis was performed to compare the effectiveness among the different CT regimens and sequences used. Results: We included a total of 49 patients with SCD usage from July 2016-January 2019. Table summarizes SCD efficacy, toxicities and CT regimens. In our study, 76% of patients had grade ≤1 CIA using SCD. 35% withdrew SCD use, with hair loss being the most common reason. 58% of patients who received upfront anthracycline-cyclophosphamide (AC) experienced grade 2 CIA. In contrast, no patients receiving taxane-only treatment had grade 2 CIA. Notably, only 3 of 16 patients (19%) who received upfront paclitaxel followed by anthracyclines developed grade 2 CIA. Conclusions: SCD proved to be highly effective in preventing grade 2 CIA with different CT regimens, including patients that received anthracycline-based regimens who started treatment with taxanes upfront. Accordingly, our results suggest that CT sequence, rather than type of CT agent may have a significant impact on the efficacy of SCD in CIA prevention. The results of larger studies are required to confirm our findings.[Table: see text]