CClinicalTrials.gg
CompletedNCT03289364Updated Apr 28, 2026Results posted

Penguin Cold Caps in the Prevention of Hair Loss in Breast Cancer Patients

An interventional study of Penguin Cold Caps in Breast Cancer, sponsored by Providence Health & Services. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-28.

Sponsored by Providence Health & Services · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
12
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this study is to estimate the efficacy of Penguin cold caps in preventing or reducing hair loss in patients receiving (neo)adjuvant chemotherapy (one of four common regimens) for early stage breast cancer.

Read the detailed description

This will be a phase II prospective, open label, non-randomized study conducted to determine the safety and efficacy of Penguin TM cold cap system in preventing or reducing chemotherapy-induced alopecia in patients with early stage breast cancer undergoing chemotherapy.

Eligible subjects will be enrolled to one of 4 study arms determined by type of chemotherapy. Subjects will have early stage breast cancer of any receptor subtype, for which standard of care includes chemotherapy. Eligible subjects will be enrolled at Providence Portland Medical Center (PPMC) and Providence St. Vincent Medical Center (PSVMC).

The PenguinTM cold cap therapy will be administered to all enrolled subjects according to the dosing schedule specified by the study arms. PenguinTM cold caps is a portable scalp cooling system which uses gel-filled cold caps that are cooled on dry ice and exchanged every 30 minutes in order to maintain optimum temperature. Its unique crylon gel formula is specifically created to maintain cold temperatures for much longer periods of time than other conventional cooling gels and foams. No scalp preparation is required before use.

02

Conditions studied

  • Breast Cancer

Keywords

  • Breast Cancer
  • Alopecia
  • Hair Loss
  • Scalp Cooling
  • Penguin Cold Caps
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • At least ≥ 18 years of age
  • Diagnosis of stage I-III breast cancer for whom neoadjuvant or adjuvant cytotoxic chemotherapy (ACT/HP, TCH/P, TC, or T/H) is planned.
  • Willing and able to provide informed consent.
  • Availability of caretaker(s) to accompany participant and facilitate cold-cap placement/exchanges using the recommended technique.
  • Women of childbearing potential must use acceptable measures to avoid becoming pregnant during study period and for 30 days after last dose of chemotherapy.

Exclusion criteria

Exclusion Criteria:

  • Pre-existing alopecia (Dean's scale ≥ 1)
  • Another malignancy that required active treatment with systemic chemotherapy within 2 years of study recruitment.
  • Prior radiotherapy treatment involving head.
  • Pre-existing chronic severe headaches or migraines.
  • Skin conditions that in the opinion of PI would be at risk of worsening with study.
  • Cold sensitivity or cold agglutinin disease
  • Cryoglobulinemia
  • Cryofibrogenemia
  • History of current evidence of any condition, therapy or abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, such that trial participation is not in the best interest of the subject.
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
12 participants (actual)

Study arms

  • Experimental
    Penguin Cold Caps

    Penguin Cold-cap therapy will commence at least 50 minutes prior to chemotherapy infusion, and will continue for 4 hours following completion of chemotherapy.

    Device: Penguin Cold Caps

Interventions

  • DevicePenguin Cold Caps

    Patients will wear Penguin Cold Cap scalp cooling device prior to each chemotherapy administration, during administration, and for four hours following administration.

05

What researchers measure

Primary outcomes

  1. Efficacy of PenguinTM Cold-caps for Prevention or Reduction of CIA

    Efficacy will be reported as the proportion of evaluable subjects in each arm who achieve a score of 0-2 on the Dean's alopecia scale (i.e. less than 50% hair loss by standardized photography) at the 30-day post-chemotherapy assessment visit. A modified intention-to-treat (ITT) analysis will be followed whereby all subjects receiving at least 75% of prescribed chemotherapy dose will be considered evaluable (those receiving less chemotherapy are excluded to minimize confounding effect of chemotherapy dose). Subjects who withdraw consent prior to efficacy assessment will constitute treatment failures according to the intention-to-treat principle. Dean's alopecia scale is as follows: Grade 0 indicates no hair loss, Grade 1 indicates up to 25% hair loss, Grade 2 indicates greater than 25% hair loss up to 50% hair loss, Grade 3 indicates greater than 50% hair loss up to 75% hair loss, and Grade 4 indicates greater than 75% hair loss.

    Time frame: 30 days post chemotherapy treatment

Secondary outcomes

  1. "Was It Worth It?" Questionnaire Exit Interview

    Patient reported outcomes (PROs) will be reported as the proportion of patients (and confidence intervals) reporting the study cold-cap therapy as positive and beneficial for the WIWI scale.

    Time frame: 30 days post chemotherapy treatment

  2. EORTC QLQ-C30 Exit Interview

    Optional patient reported outcomes (PROs) for European Organization for Research and Treatment of Cancer: Quality of Life Core-30 (EORTC QLQ-C30), version 3.0. The EORTC QLQ-C30 covers five functional scales and three symptom scales. Scores range from 0 to 100 with higher scores indicate a better quality of life/outcome 30 days post chemotherapy treatment.

    Time frame: 30 days post chemotherapy treatment

  3. BR23 Exit Interview

    Patient reported outcome (PRO) using the European Organization for Research and Treatment of Cancer: Quality of Life Breast Cancer Module (EORTC QLQ-BR23) and body image scale (BIS). For the QLQ-BR23, scores range from 0 to 100, with higher scores indicating better quality of life for patients. For the BIS, scores range from 0 to 30, with a higher score indicating a higher level of body image disturbance.

    Time frame: 30 days post chemotherapy

06

Results

Posted Apr 28, 2026

Participant flow

Participant flow — Overall Study
MilestonePenguin Cold Caps
Started12
Completed10
Not completed2
Withdrew: Withdrawal by subject2

Outcome measures

PrimaryEfficacy of PenguinTM Cold-caps for Prevention or Reduction of CIA

Efficacy will be reported as the proportion of evaluable subjects in each arm who achieve a score of 0-2 on the Dean's alopecia scale (i.e. less than 50% hair loss by standardized photography) at the 30-day post-chemotherapy assessment visit. A modified intention-to-treat (ITT) analysis will be followed whereby all subjects receiving at least 75% of prescribed chemotherapy dose will be considered evaluable (those receiving less chemotherapy are excluded to minimize confounding effect of chemotherapy dose). Subjects who withdraw consent prior to efficacy assessment will constitute treatment failures according to the intention-to-treat principle. Dean's alopecia scale is as follows: Grade 0 indicates no hair loss, Grade 1 indicates up to 25% hair loss, Grade 2 indicates greater than 25% hair loss up to 50% hair loss, Grade 3 indicates greater than 50% hair loss up to 75% hair loss, and Grade 4 indicates greater than 75% hair loss.

Time frame:
30 days post chemotherapy treatment
Reported as:
Count of participants · Participants
Efficacy of PenguinTM Cold-caps for Prevention or Reduction of CIA
ParticipantsPenguin Cold Caps
Dean's score 04
Dean's score 13
Dean's score 23
Secondary"Was It Worth It?" Questionnaire Exit Interview

Patient reported outcomes (PROs) will be reported as the proportion of patients (and confidence intervals) reporting the study cold-cap therapy as positive and beneficial for the WIWI scale.

Time frame:
30 days post chemotherapy treatment
Reported as:
Number · participants
"Was It Worth It?" Questionnaire Exit Interview
participantsPenguin Cold Caps
Study participation was worthwhile9
Recommended to others10
Worth repeat participation8
Subjects reporting improved quality of life (QOL)5
Better experience than expected5
SecondaryEORTC QLQ-C30 Exit Interview

Optional patient reported outcomes (PROs) for European Organization for Research and Treatment of Cancer: Quality of Life Core-30 (EORTC QLQ-C30), version 3.0. The EORTC QLQ-C30 covers five functional scales and three symptom scales. Scores range from 0 to 100 with higher scores indicate a better quality of life/outcome 30 days post chemotherapy treatment.

Time frame:
30 days post chemotherapy treatment
Reported as:
Mean · score on a scale
EORTC QLQ-C30 Exit Interview
score on a scalePenguin Cold Caps
Global Health Status64.58 ± 19.8
Functional Scale: Physical84.17 ± 16.3
Functional Scale: Role62 ± 21.7
Functional Scale: Emotional69.79 ± 24.8
Functional Scale: Cognitive64.58 ± 22.6
Functional Scale: Social70.84 ± 26.3
Symptom Scale: Financial Difficulties33.33 ± 39.8
SecondaryBR23 Exit Interview

Patient reported outcome (PRO) using the European Organization for Research and Treatment of Cancer: Quality of Life Breast Cancer Module (EORTC QLQ-BR23) and body image scale (BIS). For the QLQ-BR23, scores range from 0 to 100, with higher scores indicating better quality of life for patients. For the BIS, scores range from 0 to 30, with a higher score indicating a higher level of body image disturbance.

Time frame:
30 days post chemotherapy
Reported as:
Mean · score on a scale
BR23 Exit Interview
score on a scalePenguin Cold Caps
Functional Scales (BR23): Body Image64.58 ± 21.7
Functional Scales (BR23): Future Perspective41.67 ± 29.6
Symptom Scale (BIS): Upset by Hair Loss4.17 ± 23.5

Adverse events

Collected over 11 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Penguin Cold Caps0/10 (0%)0/10 (0%)10/10 (100%)
Most frequent other events
Most frequent other events
EventPenguin Cold Caps
NauseaGastrointestinal disorders9/10
HeadacheNervous system disorders2/10
VomitingGastrointestinal disorders2/10
Head SoreSkin and subcutaneous tissue disorders1/10
SyncopeNervous system disorders1/10

Baseline characteristics

Population analyzed reduced to 10 for publication due to two patients withdrawing before Cycle 1.

Age, Continuous
Age, Continuous(years)Penguin Cold Caps
Median49 (44 to 59)
Sex: Female, Male
Sex: Female, Male(Participants)Penguin Cold Caps
Female10
Male0
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Penguin Cold Caps
Hispanic or Latino2
Not Hispanic or Latino8
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Penguin Cold Caps
United States10
Menopausal Status
Menopausal Status(Participants)Penguin Cold Caps
Pre-Menopausal6
Post-Menopausal2
Unknown2
Chemotherapy Setting
Chemotherapy Setting(Participants)Penguin Cold Caps
Adjuvant4
Neoadjuvant6
Hair Thickness
Hair Thickness(Participants)Penguin Cold Caps
Fine3
Medium4
Thick3
07

Study locations

1 site
  • Providence Cancer Center
    Portland, Oregon 97213, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Jul 11, 2019
  • Informed consent form · May 4, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03289364
Lead sponsor
Providence Health & Services
Collaborators
Medical Specialties of California
Responsible party
Sponsor
First posted
Sep 20, 2017
Start date
Aug 24, 2017
Primary completion
Aug 19, 2021
Completion
Aug 19, 2021
Results posted
Apr 28, 2026
Last update
Apr 28, 2026

Study contacts

David Page, MD
principal investigator · Providence Health & Services

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion