This phase II trial compares the safety and effectiveness of topical minoxidil alone to topical minoxidil in combination with low-level red-light therapy for improving chemotherapy-induced hair loss or thinning (alopecia). Minoxidil has been approved by the Food and Drug Administration as a treatment for hair loss. It increases blood flow in the skin and may have a direct stimulatory effect on hair follicle cells, forcing them from their resting phase into their active growth phase. Low-level light therapy is regarded as a safe and medically accepted treatment for a variety of skin conditions, including acne, scars, and psoriasis. Red light wavelengths are readily absorbed into the skin and do not contain harmful ultraviolet light. When absorbed into the skin, these wavelengths stimulate fibroblasts, which are connective tissue cells that make and secrete collagen proteins. Low-level red-light therapy may improve hair loss by stimulating hair follicles. Combining minoxidil with low-level red-light therapy may be safe and more effective at improving chemotherapy-induced alopecia than minoxidil alone.
Patients will be Ohio State University patients > 18 years old
Patients will have a diagnosis of breast cancer, stages I-IV
Patients will have been treated with a chemotherapy regimen containing either an anthracycline or taxane
Patients will have a loss of at least 50% of the hair on the scalp by the final chemotherapy infusion
None
Parallel
Electronic Health Record Review
Other interventionAncillary studies
Minoxidil
DrugGiven topically
Revian RED LED-light cap
DeviceUndergo low-level red-light therapy with Revian RED LED-light cap
Survey Administration
Other interventionAncillary studies
Dean scale score
The Dean scale measures hair loss along a 4-grade scale. Grade 1 = \<25% hair loss. Grade 2= 25-50% hair loss. Grade 3=50-75% hair loss. Grade 4 = \>75% hair loss. Success will be defined as Dean scale score of 1 or 0. This will be based on clinical photographs taken at the initial and 6-month visits and scored by two board-certified dermatologists. Will construct two-sided 95% confidence intervals for improvement from baseline and differences between randomized groups, including the proportion of patients with a Dean score of 1 or 0 at 6 months.
Change in Dean scale score
The Dean scale measures hair loss along a 4-grade scale. Grade 1 = \<25% hair loss. Grade 2= 25-50% hair loss. Grade 3=50-75% hair loss. Grade 4 = \>75% hair loss.Will be reported by treatment group using summary statistics (mean and standard deviation, median and quartiles, or count and percentage, as appropriate). Will construct two-sided 95% confidence intervals for improvement from baseline and differences between randomized groups.
Change in trichoscopic hair density
Measures of hair density will be taken via trichoscopic photography by use of the HairMetrix device. Density measurements will be reported by treatment group using summary statistics (mean and standard deviation, median and quartiles, or count and percentage, as appropriate). Will construct two-sided 95% confidence intervals for improvement from baseline and differences between randomized groups.
Change in Chemotherapy Alopecia Distress Scale (CADS)
CADS is a 17-item tool that measures hair loss distress. Each question uses a 4-point likert scale (0-3), and total scores range from 0-51 with higher scores indicating greater hair loss distress. Longitudinal mixed effects linear and generalized linear or logistic models will be used with improvement from baseline as the outcome at 2, 4, 6, and 12 months. Randomization group, time point, and their interaction will be used as fixed effects, and a subject random effect will be used to account for within-subject correlation of outcomes. For CADS, baseline score will also be included as a fixed effect. TWill be reported by treatment group using summary statistics (mean and standard deviation, median and quartiles, or count and percentage, as appropriate). Will construct two-sided 95% confidence intervals for improvement from baseline and differences between randomized groups.
Change in patient reported outcomes (hair loss survey)
Participants will be asked four questions about symptoms related to hair loss over the last week. Each question is scored on a scale with possible answers ranging from 0 (not present) to 10 (as bad as you can imagine). Will be reported by treatment group using summary statistics (mean and standard deviation, median and quartiles, or count and percentage, as appropriate). Will construct two-sided 95% confidence intervals for improvement from baseline and differences between randomized groups.
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