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

Dave RV 1 , Elsberger B 2 , Taxiarchi VP 3 , Gandhi A 4 , Kirwan CC 4 , Kim B 5 Show all authors , Camacho EM 3 , Coles CE 6 , Copson E 7 , Courtney A 8 , Horgan K 5 , Fairbrother P 9 , Holcombe C 10 , Kirkham JJ 3 , Leff DR 8 , McIntosh SA 11 , O'Connell R 12 , Pardo R 13 , Potter S 14 , Rattay T 15 , Sharma N 16 , Vidya R 17 , Cutress RI 7 , B-MaP-C study collaborative

Affiliations 

  • 1 The Nightingale Breast Cancer Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK. [email protected]
  • 2 Aberdeen Royal Infirmary/University of Aberdeen, Breast Unit, Foresterhill Road, Aberdeen, AB25 2ZN, UK
  • 3 Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
  • 4 The Nightingale Breast Cancer Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
  • 5 Department of Breast Surgery, St. James's University Hospital, Leeds, LS9 7TF, UK
  • 6 Department of Oncology, University of Cambridge, Cambridge, UK
  • 7 Cancer Sciences Academic Unit, University of Southampton and University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK
  • 8 Department of Surgery and Cancer, Imperial College, London, UK
  • 9 Trustee, Independent Cancer Patients Voice, London, UK
  • 10 Linda McCartney Centre, Royal Liverpool and Broadgreen University Hospital, Prescot Street, Liverpool, L7 8XP, UK
  • 11 Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK
  • 12 Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
  • 13 Bolton NHS Foundation Trust, Minerva Rd, Farnworth, Bolton, BL4 0JR, UK
  • 14 Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Canynge Hall, Whatley Road, Bristol, BS8 2PS, UK
  • 15 Leicester Cancer Research Centre, Clinical Sciences Building, University of Leicester, Leicester, LE2 2LX, UK
  • 16 Breast Unit, Level 1 Chancellor Wing, St James's Hospital, Leeds, LS9 7TF, UK
  • 17 The Royal Wolverhampton NHS Trust, Wolverhampton Road, Wolverhampton, WV10 0QP, UK
Breast Cancer Res Treat, 2023 Apr 03.
PMID: 37010651 DOI: 10.1007/s10549-023-06893-4

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 (

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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