Outcomes of oral dutasteride and oral minoxidil for treating endocrine therapy-induced alopecia from breast cancer treatment: A case series

Summary: Abstract Body: This case series explores the utility of oral minoxidil and dutasteride for treating endocrine-therapy induced alopecia (EIA) in real life scenarios. Patients with hormone receptor positive breast cancers commonly require long term maintenance treatment with endocrine therapy. The estrogen receptor blockade suppresses estrogen systemically, causing EIA in 15-33% of patients. This pathogenesis closely resembles the hormonally-driven hair loss in androgenic alopecia (AA). There are no FDA-approved treatments for EIA, however, oral minoxidil and dutasteride have shown promising results for AA and may also be advantageous in EIA. Seven patients with EIA were treated with oral minoxidil 1.25 mg (four patients) or dutasteride 0.5 mg (three patients) daily for at least three months. Pretreatment and posttreatment photographs were compared by two independent dermatologist reviewers using the standardized global photographic assessment to quantify change in hair density on a 7-point scale. The average patient age was 62 years (range 48-80) and the average treatment duration was 365 days (range 112-547). All dutasteride patients demonstrated mild-to-moderate improvement in hair density (+1 to +2). Of the minoxidil patients, two had moderate improvement in hair density (+2) and two had mild improvement (0.5 to +1). Oral dutasteride and minoxidil may provide promising treatment options for patients experiencing EIA. Response to oral therapies is likely multifactorial and influenced by age, EIA medication, treatment duration, and other patient factors. Prospective controlled studies exploring treatment efficacy for EIA and patient factors associated with better response to oral therapies are warranted. Abigail Katz¹, Celina Dubin², Katrina A. David², Benjamin Ungar², Nicholas Gulati², Angela Lamb² 1. Icahn School of Medicine at Mount Sinai, New York, NY, United States. 2. Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States. Clinical Research: Interventional Research