Abstract PS1-02-18: Enhanced Scalp Cooling Efficacy in Breast Cancer Patients Through Team-Based Care and Regimen-Specific Protocol Optimization: A Single-Institution Study and Review

Abstract Background: Chemotherapy-induced alopecia (CIA) significantly impacts patients' quality of life (QoL). While scalp cooling therapy (SCT) offers a proven method for preventing CIA, its widespread implementation faces various challenges. Objective: This study aimed to evaluate the impact of a refined team-based approach and optimized protocols on scalp cooling therapy (SCT) efficacy in breast cancer patients. Methods: A retrospective observational study compared SCT outcomes in breast cancer patients before and after implementing a refined team-based approach (Group A vs. Group B), supplemented by a concise literature review. Results: Our institutional experience demonstrated improved efficacy in preventing alopecia with enhanced team collaboration and the active involvement of appearance care professionals, including hairdressers. Importantly, chemotherapy regimen sequencing significantly influenced outcomes. In Group A, patients receiving weekly paclitaxel followed by dose-dense doxorubicin/cyclophosphamide (wPTX f/b ddAC) had a significantly shorter average number of Grade 2 or higher alopecia cycles (mean: 1.007, median: 0.5) compared to those receiving the reverse sequence (ddAC f/b wPTX, mean: 2.870, median: 3.0) (P = 0.0006). In Group B, while wPTX f/b ddAC also showed a shorter average (mean: 0.448, median: 0.0) compared to ddAC f/b wPTX (mean: 0.800, median: 0.0), this difference did not reach statistical significance (P = 0.0543), potentially reflecting the overall improved efficacy in this group. For patients receiving wPTX f/b ddAC, the percentage of Grade 2 alopecia at the end of treatment was 44.8% in Group B, significantly lower than 69.2% in Group A. The overall proportion of time spent in Grade 2 alopecia during the entire treatment period also demonstrated a shorter duration in Group B (6.5%) compared to Group A (17.3%). Furthermore, comparing the average number of cycles with Grade 2 or higher alopecia, Group B (0.448 cycles) demonstrated a significantly shorter duration compared to Group A (1.007 cycles; P=0.0055). For ddAC f/b wPTX, Group B (0.800 cycles) also showed a significantly shorter average number of cycles with Grade 2 or higher alopecia compared to Group A (2.870 cycles; P=0.0003). For TC therapy, the average number of cycles with Grade 2 or higher alopecia did not yield a statistically significant difference (Group A: 3.000 cycles; Group B: 2.550 cycles; P=0.1176). For the PEM/Cb/wPTX→PEM/AC regimen, Group B (0.000 cycles) demonstrated a significantly shorter average compared to Group A (3.000 cycles; P=0.0002). Conclusion: Maximizing SCT efficacy requires not only technical proficiency but also a comprehensive multidisciplinary team approach and personalized, high-quality care. Specifically, optimized chemotherapy regimen sequencing, alongside the active involvement of appearance care professionals like hairdressers, significantly enhances efficacy. This study highlights their crucial role in improving future SCT dissemination and quality. Citation Format: N. Tamura, Y. Nagaoka, Y. Sano, Y. Kobayashi, K. Tanaka, M. Kurikawa, A. Shibata, Y. Tanabe, Y. Yamaguchi, Y. Oda, M. Ogura, R. Okamoto, H. Kawabata. Enhanced Scalp Cooling Efficacy in Breast Cancer Patients Through Team-Based Care and Regimen-Specific Protocol Optimization: A Single-Institution Study and Review [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-02-18.