Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study

B-MaP-C study collaborative; Rajiv V Dave; Beatrix Elsberger; Vicky P Taxiarchi; Ashu Gandhi; Cliona C Kirwan; Baek Kim; Elizabeth M Camacho; Charlotte E Coles; Ellen Copson; Alona Courtney; Kieran Horgan; Patricia Fairbrother; Chris Holcombe; Jamie J Kirkham; Daniel R Leff; Stuart A McIntosh; Rachel O'Connell; Ricardo Pardo; Shelley Potter; Tim Rattay; Nisha Sharma; Raghavan Vidya; Ramsey I Cutress

doi:10.1007/s10549-023-06893-4

Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study

B-MaP-C study collaborative
, Rajiv V Dave^*
, Beatrix Elsberger
, Vicky P Taxiarchi
, Ashu Gandhi
, Cliona C Kirwan
, Baek Kim
, Elizabeth M Camacho
, Charlotte E Coles
, Ellen Copson
, Alona Courtney
, Kieran Horgan
, Patricia Fairbrother
, Chris Holcombe
, Jamie J Kirkham
, Daniel R Leff
, Stuart A McIntosh
, Rachel O'Connell
, Ricardo Pardo
, Shelley Potter

Tim Rattay, Nisha Sharma, Raghavan Vidya, Ramsey I Cutress

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

5 Citations (Scopus)

Abstract

PURPOSE: The B-MaP-C study investigated changes to breast cancer care that were necessitated by the COVID-19 pandemic. Here we present a follow-up analysis of those patients commenced on bridging endocrine therapy (BrET), whilst they were awaiting surgery due to reprioritisation of resources.

METHODS: This multicentre, multinational cohort study recruited 6045 patients from the UK, Spain and Portugal during the peak pandemic period (Feb-July 2020). Patients on BrET were followed up to investigate the duration of, and response to, BrET. This included changes in tumour size to reflect downstaging potential, and changes in cellular proliferation (Ki67), as a marker of prognosis.

RESULTS: 1094 patients were prescribed BrET, over a median period of 53 days (IQR 32-81 days). The majority of patients (95.6%) had strong ER expression (Allred score 7-8/8). Very few patients required expedited surgery, due to lack of response (1.2%) or due to lack of tolerance/compliance (0.8%). There were small reductions in median tumour size after 3 months' treatment duration; median of 4 mm [IQR - 20, 4]. In a small subset of patients (n = 47), a drop in cellular proliferation (Ki67) occurred in 26 patients (55%), from high (Ki67 ≥ 10%) to low (< 10%), with at least one month's duration of BrET.

DISCUSSION: This study describes real-world usage of pre-operative endocrine therapy as necessitated by the pandemic. BrET was found to be tolerable and safe. The data support short-term (≤ 3 months) usage of pre-operative endocrine therapy. Longer-term use should be investigated in future trials.

Original language	English
Pages (from-to)	265-279
Number of pages	15
Journal	Breast Cancer Research and Treatment
Volume	199
Issue number	2
DOIs	https://doi.org/10.1007/s10549-023-06893-4
Publication status	Published - 3 Apr 2023

Bibliographical note

Funding Information:
Baek Kim, Alona Courtney, Rachel O’Connell, Vicky P Taxiarchi, Raghavan Vidya, Jamie J Kirkham, Patricia Fairbrother, Nisha Sharma, Christopher W.J. Cartlidge, Kieran Horgan, Shelley Potter, Ashu Gandhi, Stuart A McIntosh, Elizabeth Camacho, Daniel R Leff and Chris Holcombe have nothing to declare. Rajiv V Dave (RVD) has received honoraria from Roche and support from Endomag. Dr Tim Rattay (TR) is currently an NIHR Clinical Lecturer. Charlotte E Coles (CEC) is supported by the National Institute Health Research Cambridge Biomedical Research Centre. Ramsey I Cutress (RIC) has equipment provided by Seca to analyse body composition to University Hospital Southampton as part of a NIHR model industry collaborative agreement (MiCA). This equipment is used in an Academic Investigator led charity funded study of which Ramsey Cutress is CI. Ellen Copson (EC) declares honoraria from: Roche, Pfizer, Astra-Zeneca, Lilly, Nanostring and expert panel work for World Cancer Research Fund. Cliona C Kirwan (CCK) is Royal College of Surgeons/University of Manchester Professor of Surgical trials funded by a Royal College of Surgeons of England / Masonic Charitable Foundation professorship.

Publisher Copyright:
© 2023, The Author(s).

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This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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B-MaP-C study collaborative, Dave, R. V., Elsberger, B., Taxiarchi, V. P., Gandhi, A., Kirwan, C. C., Kim, B., Camacho, E. M., Coles, C. E., Copson, E., Courtney, A., Horgan, K., Fairbrother, P., Holcombe, C., Kirkham, J. J., Leff, D. R., McIntosh, S. A., O'Connell, R., Pardo, R., ... Cutress, R. I. (2023). Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study. Breast Cancer Research and Treatment, 199(2), 265-279. https://doi.org/10.1007/s10549-023-06893-4

@article{3b218e0f46884115bad298766234cf36,

title = "Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study",

abstract = "PURPOSE: The B-MaP-C study investigated changes to breast cancer care that were necessitated by the COVID-19 pandemic. Here we present a follow-up analysis of those patients commenced on bridging endocrine therapy (BrET), whilst they were awaiting surgery due to reprioritisation of resources.METHODS: This multicentre, multinational cohort study recruited 6045 patients from the UK, Spain and Portugal during the peak pandemic period (Feb-July 2020). Patients on BrET were followed up to investigate the duration of, and response to, BrET. This included changes in tumour size to reflect downstaging potential, and changes in cellular proliferation (Ki67), as a marker of prognosis.RESULTS: 1094 patients were prescribed BrET, over a median period of 53 days (IQR 32-81 days). The majority of patients (95.6\%) had strong ER expression (Allred score 7-8/8). Very few patients required expedited surgery, due to lack of response (1.2\%) or due to lack of tolerance/compliance (0.8\%). There were small reductions in median tumour size after 3 months' treatment duration; median of 4 mm [IQR - 20, 4]. In a small subset of patients (n = 47), a drop in cellular proliferation (Ki67) occurred in 26 patients (55\%), from high (Ki67 ≥ 10\%) to low (< 10\%), with at least one month's duration of BrET.DISCUSSION: This study describes real-world usage of pre-operative endocrine therapy as necessitated by the pandemic. BrET was found to be tolerable and safe. The data support short-term (≤ 3 months) usage of pre-operative endocrine therapy. Longer-term use should be investigated in future trials.",

author = "\{B-MaP-C study collaborative\} and Dave, \{Rajiv V\} and Beatrix Elsberger and Taxiarchi, \{Vicky P\} and Ashu Gandhi and Kirwan, \{Cliona C\} and Baek Kim and Camacho, \{Elizabeth M\} and Coles, \{Charlotte E\} and Ellen Copson and Alona Courtney and Kieran Horgan and Patricia Fairbrother and Chris Holcombe and Kirkham, \{Jamie J\} and Leff, \{Daniel R\} and McIntosh, \{Stuart A\} and Rachel O'Connell and Ricardo Pardo and Shelley Potter and Tim Rattay and Nisha Sharma and Raghavan Vidya and Cutress, \{Ramsey I\} and Fairhurst, \{Katherine J\}",

note = "Funding Information: Baek Kim, Alona Courtney, Rachel O{\textquoteright}Connell, Vicky P Taxiarchi, Raghavan Vidya, Jamie J Kirkham, Patricia Fairbrother, Nisha Sharma, Christopher W.J. Cartlidge, Kieran Horgan, Shelley Potter, Ashu Gandhi, Stuart A McIntosh, Elizabeth Camacho, Daniel R Leff and Chris Holcombe have nothing to declare. Rajiv V Dave (RVD) has received honoraria from Roche and support from Endomag. Dr Tim Rattay (TR) is currently an NIHR Clinical Lecturer. Charlotte E Coles (CEC) is supported by the National Institute Health Research Cambridge Biomedical Research Centre. Ramsey I Cutress (RIC) has equipment provided by Seca to analyse body composition to University Hospital Southampton as part of a NIHR model industry collaborative agreement (MiCA). This equipment is used in an Academic Investigator led charity funded study of which Ramsey Cutress is CI. Ellen Copson (EC) declares honoraria from: Roche, Pfizer, Astra-Zeneca, Lilly, Nanostring and expert panel work for World Cancer Research Fund. Cliona C Kirwan (CCK) is Royal College of Surgeons/University of Manchester Professor of Surgical trials funded by a Royal College of Surgeons of England / Masonic Charitable Foundation professorship. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = apr,

day = "3",

doi = "10.1007/s10549-023-06893-4",

language = "English",

volume = "199",

pages = "265--279",

journal = "Breast Cancer Research and Treatment",

issn = "0167-6806",

publisher = "Springer",

number = "2",

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B-MaP-C study collaborative, Dave, RV, Elsberger, B, Taxiarchi, VP, Gandhi, A, Kirwan, CC, Kim, B, Camacho, EM, Coles, CE, Copson, E, Courtney, A, Horgan, K, Fairbrother, P, Holcombe, C, Kirkham, JJ, Leff, DR, McIntosh, SA, O'Connell, R, Pardo, R, Potter, S, Rattay, T, Sharma, N, Vidya, R & Cutress, RI 2023, 'Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study', Breast Cancer Research and Treatment, vol. 199, no. 2, pp. 265-279. https://doi.org/10.1007/s10549-023-06893-4

TY - JOUR

T1 - Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic

T2 - outcomes from the B-MaP-C study

AU - B-MaP-C study collaborative

AU - Dave, Rajiv V

AU - Elsberger, Beatrix

AU - Taxiarchi, Vicky P

AU - Gandhi, Ashu

AU - Kirwan, Cliona C

AU - Kim, Baek

AU - Camacho, Elizabeth M

AU - Coles, Charlotte E

AU - Copson, Ellen

AU - Courtney, Alona

AU - Horgan, Kieran

AU - Fairbrother, Patricia

AU - Holcombe, Chris

AU - Kirkham, Jamie J

AU - Leff, Daniel R

AU - McIntosh, Stuart A

AU - O'Connell, Rachel

AU - Pardo, Ricardo

AU - Potter, Shelley

AU - Rattay, Tim

AU - Sharma, Nisha

AU - Vidya, Raghavan

AU - Cutress, Ramsey I

AU - Fairhurst, Katherine J

N1 - Funding Information: Baek Kim, Alona Courtney, Rachel O’Connell, Vicky P Taxiarchi, Raghavan Vidya, Jamie J Kirkham, Patricia Fairbrother, Nisha Sharma, Christopher W.J. Cartlidge, Kieran Horgan, Shelley Potter, Ashu Gandhi, Stuart A McIntosh, Elizabeth Camacho, Daniel R Leff and Chris Holcombe have nothing to declare. Rajiv V Dave (RVD) has received honoraria from Roche and support from Endomag. Dr Tim Rattay (TR) is currently an NIHR Clinical Lecturer. Charlotte E Coles (CEC) is supported by the National Institute Health Research Cambridge Biomedical Research Centre. Ramsey I Cutress (RIC) has equipment provided by Seca to analyse body composition to University Hospital Southampton as part of a NIHR model industry collaborative agreement (MiCA). This equipment is used in an Academic Investigator led charity funded study of which Ramsey Cutress is CI. Ellen Copson (EC) declares honoraria from: Roche, Pfizer, Astra-Zeneca, Lilly, Nanostring and expert panel work for World Cancer Research Fund. Cliona C Kirwan (CCK) is Royal College of Surgeons/University of Manchester Professor of Surgical trials funded by a Royal College of Surgeons of England / Masonic Charitable Foundation professorship. Publisher Copyright: © 2023, The Author(s).

PY - 2023/4/3

Y1 - 2023/4/3

N2 - PURPOSE: The B-MaP-C study investigated changes to breast cancer care that were necessitated by the COVID-19 pandemic. Here we present a follow-up analysis of those patients commenced on bridging endocrine therapy (BrET), whilst they were awaiting surgery due to reprioritisation of resources.METHODS: This multicentre, multinational cohort study recruited 6045 patients from the UK, Spain and Portugal during the peak pandemic period (Feb-July 2020). Patients on BrET were followed up to investigate the duration of, and response to, BrET. This included changes in tumour size to reflect downstaging potential, and changes in cellular proliferation (Ki67), as a marker of prognosis.RESULTS: 1094 patients were prescribed BrET, over a median period of 53 days (IQR 32-81 days). The majority of patients (95.6%) had strong ER expression (Allred score 7-8/8). Very few patients required expedited surgery, due to lack of response (1.2%) or due to lack of tolerance/compliance (0.8%). There were small reductions in median tumour size after 3 months' treatment duration; median of 4 mm [IQR - 20, 4]. In a small subset of patients (n = 47), a drop in cellular proliferation (Ki67) occurred in 26 patients (55%), from high (Ki67 ≥ 10%) to low (< 10%), with at least one month's duration of BrET.DISCUSSION: This study describes real-world usage of pre-operative endocrine therapy as necessitated by the pandemic. BrET was found to be tolerable and safe. The data support short-term (≤ 3 months) usage of pre-operative endocrine therapy. Longer-term use should be investigated in future trials.

AB - PURPOSE: The B-MaP-C study investigated changes to breast cancer care that were necessitated by the COVID-19 pandemic. Here we present a follow-up analysis of those patients commenced on bridging endocrine therapy (BrET), whilst they were awaiting surgery due to reprioritisation of resources.METHODS: This multicentre, multinational cohort study recruited 6045 patients from the UK, Spain and Portugal during the peak pandemic period (Feb-July 2020). Patients on BrET were followed up to investigate the duration of, and response to, BrET. This included changes in tumour size to reflect downstaging potential, and changes in cellular proliferation (Ki67), as a marker of prognosis.RESULTS: 1094 patients were prescribed BrET, over a median period of 53 days (IQR 32-81 days). The majority of patients (95.6%) had strong ER expression (Allred score 7-8/8). Very few patients required expedited surgery, due to lack of response (1.2%) or due to lack of tolerance/compliance (0.8%). There were small reductions in median tumour size after 3 months' treatment duration; median of 4 mm [IQR - 20, 4]. In a small subset of patients (n = 47), a drop in cellular proliferation (Ki67) occurred in 26 patients (55%), from high (Ki67 ≥ 10%) to low (< 10%), with at least one month's duration of BrET.DISCUSSION: This study describes real-world usage of pre-operative endocrine therapy as necessitated by the pandemic. BrET was found to be tolerable and safe. The data support short-term (≤ 3 months) usage of pre-operative endocrine therapy. Longer-term use should be investigated in future trials.

U2 - 10.1007/s10549-023-06893-4

DO - 10.1007/s10549-023-06893-4

M3 - Article (Academic Journal)

C2 - 37010651

SN - 0167-6806

VL - 199

SP - 265

EP - 279

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

IS - 2

ER -

Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study

Abstract

Bibliographical note

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