Universität zu Köln

Dowsett, Mitch, Ellis, Matthew J., Dixon, J. Michael, Gluz, Oleg, Robertson, John, Kates, Ronald, Suman, Vera J., Turnbull, Arran K., Nitz, Ulrike, Christgen, Matthias, Kreipe, Hans, Kuemmel, Sherko, Bliss, Judith M., Barry, Peter, Johnston, Stephen R., Jacobs, Samuel A., Ma, Cynthia X., Smith, Ian E. and Harbeck, Nadia (2020). Evidence-based guidelines for managing patients with primary ER+ HER2- breast cancer deferred from surgery due to the COVID-19 pandemic. npj Breast Cancer, 6 (1). LONDON: NATURE PUBLISHING GROUP. ISSN 2374-4677

Full text not available from this repository.

Abstract

Many patients with ER+ HER2- primary breast cancer are being deferred from surgery to neoadjuvant endocrine therapy (NeoET) during the COVID-19 pandemic. We have collated data from multiple international trials of presurgical endocrine therapy in order to provide guidance on the identification of patients who may have insufficiently endocrine-sensitive tumors and should be prioritised for early surgery or neoadjuvant chemotherapy rather than NeoET during or in the aftermath of the COVID-19 pandemic for safety or when surgical activity needs to be prioritized. For postmenopausal patients, our data provide strong support for the use of ER and PgR status at diagnosis for triaging of patients into three groups in which (taking into account clinical factors): (i) NeoET is likely to be inappropriate (Allred ER <6 or ER 6 and PgR <6) (ii) a biopsy for Ki67 analysis (on-treatment Ki67) could be considered after 2-4 weeks of NeoET (a: ER 7 or 8 and PgR <6 or b: ER 6 or 7 and PgR >= 6) or (iii) NeoET is an acceptable course of action (ER 8 and PgR >= 6). Cut-offs for percentage of cells positive are also given. For group (ii), a high early on-treatment level of Ki67 (>10%) indicates a higher priority for early surgery. Too few data were available for premenopausal patients to provide a similar treatment algorithm. These guidelines should be helpful for managing patients with early ER+ HER2- breast cancer during and in the aftermath of the COVID-19 crisis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dowsett, Mitch UNSPECIFIED UNSPECIFIED UNSPECIFIED Ellis, Matthew J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dixon, J. Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Gluz, Oleg UNSPECIFIED UNSPECIFIED UNSPECIFIED Robertson, John UNSPECIFIED UNSPECIFIED UNSPECIFIED Kates, Ronald UNSPECIFIED UNSPECIFIED UNSPECIFIED Suman, Vera J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Turnbull, Arran K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nitz, Ulrike UNSPECIFIED UNSPECIFIED UNSPECIFIED Christgen, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreipe, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuemmel, Sherko UNSPECIFIED UNSPECIFIED UNSPECIFIED Bliss, Judith M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Barry, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Johnston, Stephen R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jacobs, Samuel A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ma, Cynthia X. UNSPECIFIED UNSPECIFIED UNSPECIFIED Smith, Ian E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Harbeck, Nadia UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-330389
DOI:	10.1038/s41523-020-0168-9
Journal or Publication Title:	npj Breast Cancer
Volume:	6
Number:	1
Date:	2020
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	2374-4677
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NEOADJUVANT ANASTROZOLE; INTERNATIONAL KI67; ENDOCRINE THERAPY; TAMOXIFEN; WOMEN; LETROZOLE; TRIAL; INDEX Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33038