Is a cold cap necessary when using targeted therapies such as Herceptin (Trastuzumab) and Perjeta (Pertuzumab)?

There is little or no research available on this question, as the majority of women participating in the *Perjeta* studies had already lost their hair following standard chemotherapy treatments (without the use of cold caps) before starting targeted treatments alone. It is generally not necessary to use the cold cap with *Herceptin* (a targeted treatment for HER2+). However, *Perjeta* can cause loss of hair volume (not to the point of alopecia, but rather thinning). Some women who have had good results with standard chemotherapy choose to continue using the cold cap to avoid taking risks that could alter these results. It should be noted that Canadian oncologists do not generally mention the usefulness of cold caps with *Perjeta*. However, conflicting opinions have been issued by the pharmaceutical company *Roche* in Switzerland and the UK, citing thinning hair as one of the main frequent side effects of *Perjeta*. In Canada, very few women continue to use the cold cap with *Perjeta*, although in some parts of Europe and the USA, many women have chosen to do so instead.