Platelet-Rich Plasma Treatment for Endocrine-Induced Alopecia and Persistent Chemotherapy-Induced Alopecia in Breast Cancer Survivors: A Randomized, Controlled, Pilot Study.

BACKGROUND: Platelet-rich plasma (PRP) shows potential in treating androgenetic alopecia but lacks evidence for endocrine-induced alopecia (EIA) or persistent chemotherapy-induced alopecia (pCIA). OBJECTIVE: To evaluate safety and efficacy of PRP in breast cancer survivors with EIA or pCIA. METHODS: In this single-center, randomized, controlled trial, EIA and pCIA patients received PRP injections on one side of their scalp monthly for 3 months. Evaluations occurred at baseline and at week 12, followed by an optional cross-arm at week 24. The primary outcome was difference in global assessment scale (GAS) at week 12, assessed by a blinded investigator. Secondary outcomes included adverse events, hair-related quality of life, trichoscopic data, and circulating tumor cell (CTC) assay. RESULTS: Fifteen EIA and 12 pCIA patients enrolled. GAS improved from baseline to week 12 (+1.2 each, p < .001) but not statistically significant between treated and untreated sides ( p > .05). Hair density increased for both sides (+21 and +16 hairs/cm 2 , respectively, p < .05), without difference between the sides ( p > .05). Quality of life showed no improvement (41.1-39.4, p > .05). Adverse events included grade 1 to grade 3 scalp pain. Two of 12 CTC assays detected malignant cells in PRP, but no tumor seeding events were observed. CONCLUSION: PRP may increase hair density in EIA and pCIA patients and showed no adverse cancer outcomes or tumor seeding. Results may be confounded by possible PRP diffusion in split-scalp study design. CLINICALTRIALSGOV ID: NCT04459650.