Retrospective Cohort Study of CDK4/6-Inhibitor-Induced Alopecia in Breast Cancer Patients

November 2023 in “ Supportive Care in Cancer ”

Abena Minta, Lucy Rose, Candice Park, Bhuvaneswari Ramaswamy, Daniel G. Stover, Margaret E. Gatti‐Mays, Mathew Cherian, Nicole Williams, Preeti Sudheendra, Robert Wesolowski, Sagar Sardesai, Maryam B. Lustberg, Charles L. Loprinzi, Kathryn J. Ruddy, Elizabeth Cathcart-Rake, Stephanie Trovato, Brittany Dulmage

CDK4/6-inhibitor alopecia androgenetic alopecia vertex involvement combination therapy endocrine therapy minoxidil topical antiandrogens Rogaine

Studysummary This study found that breast cancer patients treated with CDK4/6 inhibitors plus endocrine therapy experienced more pronounced vertex hair loss and were less responsive to minoxidil treatment compared to those on endocrine monotherapy.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This retrospective cohort study investigated 28 breast cancer patients who developed alopecia due to CDK4/6-inhibitor therapy, termed CDKiA. The alopecia resembled androgenetic alopecia, with more pronounced vertex involvement in patients receiving combination therapy with CDK4/6i and endocrine therapy (ET) compared to those on endocrine monotherapy. After 4-6 months of minoxidil treatment, 80% of CDKiA patients showed moderate to significant improvement, while 94.4% of those with endocrine-induced alopecia (EIA) improved. The study suggests that combining minoxidil with topical antiandrogens may be beneficial for CDKiA patients, especially due to the specific vertex involvement.

View this study on doi.org →

Discuss this study in the Community →

Research cited in this study

15 / 15 results

Cyclin-Dependent Kinase 4/6 Inhibitors and Dermatologic Adverse Events: Results from the EADV Task Force Dermatology for Cancer Patients International Study

research Cyclin-Dependent Kinase 4/6 Inhibitors and Dermatologic Adverse Events: Results from the EADV Task Force Dermatology for Cancer Patients International Study

1 citations , July 2023 in “Cancers”

In this multicentric retrospective study, researchers reported that cutaneous adverse events were common among advanced breast cancer patients treated with cyclin-dependent kinase inhibitors (CDK4/6i), generally mild, and manageable with topical treatments, though in some cases, they led to treatment discontinuation.

research Efficacy of Low-Dose Oral Minoxidil in the Management of Anticancer Therapy-Induced Alopecia in Patients With Breast Cancer: A Retrospective Cohort Study

December 2022 in “Journal of The American Academy of Dermatology”

This letter highlights the lack of evidence on managing persistent alopecia induced by chemotherapy and endocrine therapy in breast cancer patients, noting that prior studies have not included endocrine therapy-induced alopecia.

research Comparison of Oral Minoxidil, Finasteride, and Dutasteride for Treating Androgenetic Alopecia

1 citations , August 2022 in “Journal of Dermatological Treatment”

In this study, the authors reported that oral dutasteride at 0.5 mg/day showed a probable greater efficacy in treating male androgenetic alopecia compared to finasteride and minoxidil, but it may cause sexual dysfunction and neuropsychiatric side effects.

research Clinical Aspects, Pathogenesis, and Therapy Options of Alopecia Induced by Hormonal Therapy for Breast Cancer

2 citations , October 2021 in “Exploration of targeted anti-tumor therapy”

This review describes oncotherapy-induced alopecia in patients receiving hormone therapy for hormone-receptor-positive breast cancer and concludes that topical hormones should not be used due to oncogenic potential.

research Patient, Oncologist, And Payer Preferences For Adjuvant Endocrine Therapy And CDK4/6 Inhibitor Regimens In Early-Stage Breast Cancer: A Discrete Choice Experiment

12 citations , March 2021 in “Patient Preference and Adherence”

This study found that patients, oncologists, and payers prioritize a significant improvement in efficacy to justify the added risks and costs when considering CDK4/6 inhibitors combined with endocrine therapy for early-stage breast cancer.

A Novel Topical Combination of Minoxidil and Spironolactone for Androgenetic Alopecia: Clinical, Histopathological, and Physicochemical Study

research A Novel Topical Combination of Minoxidil and Spironolactone for Androgenetic Alopecia: Clinical, Histopathological, and Physicochemical Study

10 citations , December 2020 in “Dermatologic Therapy”

This study found that topical minoxidil 5% gel and spironolactone 1% gel were both effective treatments for androgenetic alopecia, with a combination of both providing the best clinical response and achieving 100% effectiveness among participants.

research Spironolactone Use Does Not Increase the Risk of Female Breast Cancer Recurrence: A Retrospective Analysis

10 citations , May 2020 in “Journal of The American Academy of Dermatology”

This study found that spironolactone was not independently associated with increased breast cancer recurrence and may be considered for treating alopecia in survivors.

research A Review of the Treatment of Male Pattern Hair Loss

53 citations , February 2020 in “Expert Opinion on Pharmacotherapy”

This review discusses pharmacologic and non-pharmacologic treatments for androgenetic alopecia, noting that current medications like finasteride and minoxidil can slow hair loss but only partially restore hair growth, with early treatment offering better outcomes.

research CDK4/6 Inhibition Mitigates Stem Cell Damage in a Novel Model for Taxane-Induced Alopecia

58 citations , September 2019 in “EMBO Molecular Medicine”

This study found that the CDK4/6 inhibitor palbociclib may protect human hair follicles from the damaging effects of taxane chemotherapy by inducing G1 arrest in stem/progenitor cells.

research CDK4/6 Plus Aromatase Inhibitor-Induced Alopecia in Breast Cancer Patients

4 citations , May 2019 in “Journal of Clinical Oncology”

This study found that cyclin-dependent kinase 4/6 inhibitors used for metastatic breast cancer caused alopecia resembling androgenetic alopecia, negatively impacting patients' quality of life, but topical minoxidil showed potential for improvement.

research Safety of 5α-Reductase Inhibitors and Spironolactone in Breast Cancer Patients Receiving Endocrine Therapies

22 citations , November 2018 in “Breast Cancer Research and Treatment”

In this review, researchers found no evidence of interactions between 5α-reductase inhibitors or spironolactone and endocrine therapies for breast cancer, with no consistent changes in estrogen levels or increased breast cancer risk associated with spironolactone usage.

research Hair Disorders in Patients with Cancer

53 citations , April 2018 in “Journal of The American Academy of Dermatology”

This article reviews therapy-related hair disorders in oncology patients, detailing underlying mechanisms and potential management strategies, but reports no new clinical findings.

research Endocrine Therapy-Induced Alopecia in Patients With Breast Cancer

67 citations , April 2018 in “JAMA Dermatology”

This study found that endocrine therapy for breast cancer is associated with a pattern of hair loss similar to androgenetic alopecia, negatively impacting quality of life despite mild severity.

research Alopecia With Endocrine Therapies in Patients With Cancer

48 citations , September 2013 in “Oncologist”

This study reported that alopecia is a common but often underreported side effect of endocrine-based cancer therapies, with tamoxifen showing the highest incidence of hair loss among analyzed treatments.

research A New Classification of Pattern Hair Loss That Is Universal for Men and Women: Basic and Specific (BASP) Classification

125 citations , May 2007 in “Journal of The American Academy of Dermatology”

This study describes the development of the BASP classification system, providing a universal and systematic approach for classifying pattern hair loss in both men and women.