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

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 (Table 5) 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.

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:

- 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.