Breast CancerNCT03176888
Health Benefits of HIT for Breast Cancer Patients
A study testing Reduced-exertion, high-intensity interval training (REHIT) and Cognitive behavioral therapy (CBT) in people with Breast Cancer, run by University of Stirling at 1 site in United Kingdom.
Trial summary
Treatment of cancer patients should not only involve removing the cancer, but should also focus on maintaining good health and well-being and quality of life. This can be done by offering patients suitable rehabilitation programmes. Read more about this study
- Who is it for?
- Ages 35 to 60 years, women only
- Conditions the study is for
- Breast Cancer
- What is being tested?
- Reduced-exertion, high-intensity interval training (REHIT) and Cognitive behavioral therapy (CBT)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 0 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- 1 May 2019to 31 Dec 2019
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 35 to 60 years
- Women only
- No healthy volunteers
- Adult
Who may be able to join
- Recent diagnosis of biopsy-proven primary invasive breast cancer
- Pre- or post-menopausal women
- World Health Organisation Performance status 0-2
- No distant metastasis
- On a treatment plan of:
- surgery (breast conservation surgery or mastectomy with or without reconstruction, including axillary surgery)
Show all 11Show fewer
- Adjuvant treatment with hormonal therapy and/or radiotherapy
- Adjuvant chemotherapy with or without anti-Her-2 therapy
- Can start the study within 1 week of diagnosis and prior to surgery
- Have surgery arranged within 1-4 weeks of diagnosis
- All receptor statuses are eligible
Who cannot join
- BMI > 35 kg·m-2
- Age < 35 y or > 60 y
- Men
- Verbal self-report of undertaking five or more structured exercise sessions per week, perceived as being moderate-to-vigorous intensity, and each session being ≥ 30 minutes in duration
- Contraindications to exercise as determined using the Physical Activity Readiness Questionnaire (PAR-Q)
- Any known significant cardiovascular (except controlled hypertension), pulmonary (except treated/controlled asthma) or metabolic disease (except hypercholesterolemia or type II diabetes)
Show all 13Show fewer
- Auto-immune disease or exercise-limiting inflammatory arthritis
- Distant metastasis
- Secondary breast cancer or previous diagnosis of invasive cancer and treatment within last 5 years except
- Localised basal cell carcinoma or squamous cell carcinoma of skin
- In situ melanoma
- Cervical intraepithelial neoplasia (CIN)
- Neoadjuvant chemotherapy
Trial locations and contacts
1 site in 1 country.
About this study
Official title: The Efficacy of Reduced-exertion High-intensity Interval Training for Improving Health and Well-being in Newly Diagnosed Female Breast Cancer Patients
Treatment of cancer patients should not only involve removing the cancer, but should also focus on maintaining good health and well-being and quality of life. This can be done by offering patients suitable rehabilitation programmes. Previous research has shown that such programmes need to involve exercise alongside other components, such as psychological support. To date most studies have looked at the positive effects of moderate-intensity exercise such as brisk walking, but this type of exercise is time-consuming and often not done by many patients. Shorter-duration exercise routines consisting of repeated short sprints have been found to improve general health just as well, but one of the most time-efficient routines (termed 'reduced-exertion high-intensity interval training', or 'REHIT') has not been studied in cancer patients. REHIT involves 3 exercise sessions per week, each only 10 minutes long. This makes it an ideal routine to combine with other components of a cancer rehabilitation programme. The present study will determine whether REHIT can improve important markers of health and well-being in newly diagnosed breast cancer patients. To achieve this the investigators will recruit up to 30 patients and divide them into a group who will do REHIT before and for up to 6 weeks after their cancer surgery, and a control group who will receive standard care. Markers of health and well-being will be measured at the start of the study, ~1 week after surgery, and ~7 weeks after surgery. Any changes will be compared between the exercise group and the control group. If beneficial effects are found with the REHIT intervention then this could be more widely implemented as part of cancer treatment. This study is funded by Nuffield Health and will be performed in Oxford, UK.
Read the detailed description
This study involves a randomised controlled trial: study participants will be randomly allocated to either a group who will receive the care that they would normally have received if they would not have been in the study (control group), and a group who will receive the same standard care but will also be asked to follow a novel supervised exercise routine three times per week before their surgery and for up to 6 weeks after surgery, as well as some psychological support.
Up to 30 newly-diagnosed female breast cancer patients will be recruited. Following written informed consent, participants will be invited for a baseline testing session. This will involve a fasting blood sample (ideally at a time when the patient's medical team would take a blood sample anyway). The investigators will analyse this sample for a number of markers of health, such as blood sugar and fat levels, and markers of inflammation. The investigators will measure the patients' height with a stadiometer, and weight and body fat percentage using a special set of scales. The investigators will ask patients to complete several questionnaires that ask questions about their current well-being. Finally the investigators will measure the patients' handgrip strength as well as their fitness levels. The grip strength test involves squeezing a handheld device as hard as possible for a few seconds. The fitness test involves cycling on a stationary bike with a gradually increasing resistance until the patient cannot continue any longer because of fatigue. In this test the investigators will ask patients to breathe through a tube to determine the maximal amount of oxygen they can take up during exercise. This measure (termed VO2max) is one of the best health markers that can be measured: it is the best predictor of future risk of chronic disease or premature death. All testing sessions will be performed at the Manor Hospital in Oxford (unless the equipment required for the analysis of VO2max is not available for a period of time, in which case patients will be invited to attend Oxford Brookes campus for the fitness test; this is a 4-minute drive from the Manor Hospital).
Ideally, the blood samples will be taken in a fasted state (i.e. in the morning without having had breakfast), whereas the fitness test will be done after the patient has last had some food. The investigators will therefore provide the participants with a light snack after the blood sample has been taken. In case a patient cannot attend the hospital in the morning in a fasted state then they will arrange the session at a later time of day and the patient will not be required to be fasted (leading to loss of some of the secondary outcome measures which require a fasted state).
After the baseline testing has been completed the investigators will tell patients whether they will be in the control group or in the exercise group. Patients in the control group will receive their standard care as if they would not have participated in the study. The research team will not interact with these patients until the second testing session. Patients in the exercise group will be invited to perform 3 fully supervised exercise sessions per week at the Manor Hospital. These exercise sessions will involve 10 minutes of cycling at a low intensity, but with 2 brief cycle sprints after 2 and 6 minutes. The sprints will last 10 seconds in the first week of training, 15 seconds in the second week, and 20 seconds from week 3 onward. Training sessions will be stopped at least 2 days prior to the scheduled surgery date.
Surgery will interrupt the exercise programme. Between 7 and 10 days post-surgery, or when the consultant breast surgeon deems appropriate, all patients will undergo post-surgery testing. Testing procedures will be identical as those for baseline testing.
Following post-surgery testing, patients in the exercise group will resume the exercise programme. The duration of the sprints will restart at 10 seconds in the first week, 15 seconds in the second week, and 20 seconds in the remaining weeks. The exercise routine will be continued until follow-up treatment or for a period of up to 6 weeks. Before or after one of the 3 weekly exercise sessions, patients will receive a 30/40-minute face-to-face session with a psychologist. The aim of these sessions will be to reduce emotional distress, improve mental adjustment, promote a sense of personal control over current experience, develop effective coping strategies for dealing with cancer-related difficulties, and open expression of emotion. If patients cannot attend psychological support sessions then they will be offered the opportunity to catch up through a session over the phone.
Approximately 3 days following the final training session patients will undergo end-of-trial testing, identical to the previous two testing sessions. Patients in the control group will undergo this testing session at a time-point equivalent to that of patients in the exercise group.
- Conditions
- Breast Cancer
- Being tested
- Reduced-exertion, high-intensity interval training (REHIT), Cognitive behavioral therapy (CBT)
- Keywords
- Exercise, Aerobic capacity, Rehabilitation
- Medical subject headings
- Breast Neoplasms, Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Reduced-exertion, high-intensity interval training (REHIT)Behavioural
As in arm/group description
Cognitive behavioral therapy (CBT)Behavioural
Up to six 30/40-minute sessions of face-to-face psychotherapy will be offered based on a cognitive model of adjustment to cancer utilizing cognitive and behavioral therapy techniques as described by Moorey \& Greer (2012)
| Study group | Role | What they receive |
|---|---|---|
| Exercise | Experimental | Patients in the Exercise group will follow a fully-supervised exercise routine (Reduced-exertion, high-intensity interval training (REHIT)) with 3 weekly 10-minute training sessions consisting of easy cycling interspersed with 2 brief 'all-out' cycle sprints. Patients in this group will also be offered up to 6 sessions of cognitive behavioral therapy. The duration of the intervention will be the weeks between enrolling in the study and surgery (~1-4 weeks), as well as an additional period of up to 6 weeks following surgery. Receives: Behavioral: Reduced-exertion, high-intensity interval training (REHIT); Behavioral: Cognitive behavioral therapy (CBT) |
| Standard care | No intervention | Patients allocated to the Standard Care group will receive the care they would have also received if they would not have participated in the study. They will however undergo the same testing sessions as patients in the Exercise group. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in maximal aerobic capacity (VO2max)
VO2max is a measure of the maximal amount of exercise that can be consumed and used during exercise. It is one of the best predictors of future risk of morbidity and mortality. An increase in VO2max represents a positive change in health. The primary outcome measure is change in VO2max from baseline to 1 week post-surgery and 7 weeks post-surgery.
Measured: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Secondary outcomes (7)
Change in homeostatic model assessment of insulin resistance (HOMA-IR)
HOMA-IR is a measure of risk of type 2 diabetes and metabolic disease.
Measured: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in blood lipid profile
This includes circulating levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. These are common health markers.
Measured: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in blood pressure
Blood pressure is a common health marker.
Measured: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in body mass index (BMI)
Height and weight will be measured to calculate BMI (in kg/m^2). BMI is a common health marker.
Measured: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in grip strength
Maximal isometric grip strength assesses how hard a person can squeeze their fist. This is a good marker of risk of future morbidity.
Measured: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in mental well-being
Questionnaires will be used to determine changes in mental well-being.
Measured: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in body fat percentage
Body fat percentage (as determined using bioimpedance scales) is a common health measure.
Measured: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Jun 2017
- Study start1 May 2019
- Primary completion31 Dec 2019
- Study completion31 Dec 2019
Why it stopped: Logistical problems meant that the study was no longer feasible.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Randomized controlled trial
- Masking
- None (open label)
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Stirling
- Sponsor type
- University, hospital or other
- Collaborators
- University of Bath, Oxford Brookes University
- Responsible party
- Principal investigator, Niels Vollaard, University of Stirling
- Investigators
- Niels BJ Vollaard, PhD, Principal investigator, University of Stirling
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03176888
- Sponsor's protocol ID
- 2017 0105
- Status last verified
- Mar 2020
- First submitted
- 29 May 2017
- Last updated
- 25 Mar 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: This is a small study which will generate pilot data for larger trials. Although the investigators will publish group data there is no plan to share individual data with other researchers. However, any requests for anonymised individual data will be considered on a case-by-case basis.
Study at a glance
From the registry record, last updated by the sponsor on 25 Mar 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Efficacy of Reduced-exertion High-intensity Interval Training for Improving Health and Well-being in Newly Diagnosed Female Breast Cancer Patients
- ClinicalTrials.gov ID
- NCT03176888
- Acronym / sponsor ID
- 2017 0105
- Conditions
- Breast Cancer
- Keywords
- Exercise, Aerobic capacity, Rehabilitation
- Study type
- Interventional
- Recruitment status
- WithdrawnReason stopped: Logistical problems meant that the study was no longer feasible.
- Enrolment
- 0 participants (actual)
- Lead sponsor
- University of StirlingUniversity, hospital or other
- Collaborators
- University of Bath, Oxford Brookes University
- Study start
- 1 May 2019 (actual)
- Primary completion
- 31 Dec 2019 (actual)
- Study completion
- 31 Dec 2019 (actual)
- First posted
- 6 Jun 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Treatment of cancer patients should not only involve removing the cancer, but should also focus on maintaining good health and well-being and quality of life. This can be done by offering patients suitable rehabilitation programmes. Previous research has shown that such programmes need to involve exercise alongside other components, such as psychological support. To date most studies have looked at the positive effects of moderate-intensity exercise such as brisk walking, but this type of exercise is time-consuming and often not done by many patients. Shorter-duration exercise routines consisting of repeated short sprints have been found to improve general health just as well, but one of the most time-efficient routines (termed 'reduced-exertion high-intensity interval training', or 'REHIT') has not been studied in cancer patients. REHIT involves 3 exercise sessions per week, each only 10 minutes long. This makes it an ideal routine to combine with other components of a cancer rehabilitation programme. The present study will determine whether REHIT can improve important markers of health and well-being in newly diagnosed breast cancer patients. To achieve this the investigators will recruit up to 30 patients and divide them into a group who will do REHIT before and for up to 6 weeks after their cancer surgery, and a control group who will receive standard care. Markers of health and well-being will be measured at the start of the study, ~1 week after surgery, and ~7 weeks after surgery. Any changes will be compared between the exercise group and the control group. If beneficial effects are found with the REHIT intervention then this could be more widely implemented as part of cancer treatment. This study is funded by Nuffield Health and will be performed in Oxford, UK.
Detailed description
This study involves a randomised controlled trial: study participants will be randomly allocated to either a group who will receive the care that they would normally have received if they would not have been in the study (control group), and a group who will receive the same standard care but will also be asked to follow a novel supervised exercise routine three times per week before their surgery and for up to 6 weeks after surgery, as well as some psychological support.
Up to 30 newly-diagnosed female breast cancer patients will be recruited. Following written informed consent, participants will be invited for a baseline testing session. This will involve a fasting blood sample (ideally at a time when the patient's medical team would take a blood sample anyway). The investigators will analyse this sample for a number of markers of health, such as blood sugar and fat levels, and markers of inflammation. The investigators will measure the patients' height with a stadiometer, and weight and body fat percentage using a special set of scales. The investigators will ask patients to complete several questionnaires that ask questions about their current well-being. Finally the investigators will measure the patients' handgrip strength as well as their fitness levels. The grip strength test involves squeezing a handheld device as hard as possible for a few seconds. The fitness test involves cycling on a stationary bike with a gradually increasing resistance until the patient cannot continue any longer because of fatigue. In this test the investigators will ask patients to breathe through a tube to determine the maximal amount of oxygen they can take up during exercise. This measure (termed VO2max) is one of the best health markers that can be measured: it is the best predictor of future risk of chronic disease or premature death. All testing sessions will be performed at the Manor Hospital in Oxford (unless the equipment required for the analysis of VO2max is not available for a period of time, in which case patients will be invited to attend Oxford Brookes campus for the fitness test; this is a 4-minute drive from the Manor Hospital).
Ideally, the blood samples will be taken in a fasted state (i.e. in the morning without having had breakfast), whereas the fitness test will be done after the patient has last had some food. The investigators will therefore provide the participants with a light snack after the blood sample has been taken. In case a patient cannot attend the hospital in the morning in a fasted state then they will arrange the session at a later time of day and the patient will not be required to be fasted (leading to loss of some of the secondary outcome measures which require a fasted state).
After the baseline testing has been completed the investigators will tell patients whether they will be in the control group or in the exercise group. Patients in the control group will receive their standard care as if they would not have participated in the study. The research team will not interact with these patients until the second testing session. Patients in the exercise group will be invited to perform 3 fully supervised exercise sessions per week at the Manor Hospital. These exercise sessions will involve 10 minutes of cycling at a low intensity, but with 2 brief cycle sprints after 2 and 6 minutes. The sprints will last 10 seconds in the first week of training, 15 seconds in the second week, and 20 seconds from week 3 onward. Training sessions will be stopped at least 2 days prior to the scheduled surgery date.
Surgery will interrupt the exercise programme. Between 7 and 10 days post-surgery, or when the consultant breast surgeon deems appropriate, all patients will undergo post-surgery testing. Testing procedures will be identical as those for baseline testing.
Following post-surgery testing, patients in the exercise group will resume the exercise programme. The duration of the sprints will restart at 10 seconds in the first week, 15 seconds in the second week, and 20 seconds in the remaining weeks. The exercise routine will be continued until follow-up treatment or for a period of up to 6 weeks. Before or after one of the 3 weekly exercise sessions, patients will receive a 30/40-minute face-to-face session with a psychologist. The aim of these sessions will be to reduce emotional distress, improve mental adjustment, promote a sense of personal control over current experience, develop effective coping strategies for dealing with cancer-related difficulties, and open expression of emotion. If patients cannot attend psychological support sessions then they will be offered the opportunity to catch up through a session over the phone.
Approximately 3 days following the final training session patients will undergo end-of-trial testing, identical to the previous two testing sessions. Patients in the control group will undergo this testing session at a time-point equivalent to that of patients in the exercise group.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Randomized controlled trial
| Arm | Type | Receives |
|---|---|---|
| Exercise | Experimental | Behavioral: Reduced-exertion, high-intensity interval training (REHIT), Behavioral: Cognitive behavioral therapy (CBT)Patients in the Exercise group will follow a fully-supervised exercise routine (Reduced-exertion, high-intensity interval training (REHIT)) with 3 weekly 10-minute training sessions consisting of easy cycling interspersed with 2 brief 'all-out' cycle sprints. Patients in this group will also be offered up to 6 sessions of cognitive behavioral therapy. The duration of the intervention will be the weeks between enrolling in the study and surgery (~1-4 weeks), as well as an additional period of up to 6 weeks following surgery. |
| Standard care | No intervention | –Patients allocated to the Standard Care group will receive the care they would have also received if they would not have participated in the study. They will however undergo the same testing sessions as patients in the Exercise group. |
Who may qualify
- Ages
- 35 to 60 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (11 listed)
- Recent diagnosis of biopsy-proven primary invasive breast cancer
- Pre- or post-menopausal women
- World Health Organisation Performance status 0-2
- No distant metastasis
- On a treatment plan of:
Key exclusion criteria (13 listed)
- BMI > 35 kg·m-2
- Age < 35 y or > 60 y
- Men
- Verbal self-report of undertaking five or more structured exercise sessions per week, perceived as being moderate-to-vigorous intensity, and each session being ≥ 30 minutes in duration
- Contraindications to exercise as determined using the Physical Activity Readiness Questionnaire (PAR-Q)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Reduced-exertion, high-intensity interval training (REHIT)As in arm/group description | Behavioural | Exercise |
| Cognitive behavioral therapy (CBT)Up to six 30/40-minute sessions of face-to-face psychotherapy will be offered based on a cognitive model of adjustment to cancer utilizing cognitive and behavioral therapy techniques as described by Moorey \& Greer (2012) | Behavioural | Exercise |
Primary outcome
Change in maximal aerobic capacity (VO2max)
Time frame: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
VO2max is a measure of the maximal amount of exercise that can be consumed and used during exercise. It is one of the best predictors of future risk of morbidity and mortality. An increase in VO2max represents a positive change in health. The primary outcome measure is change in VO2max from baseline to 1 week post-surgery and 7 weeks post-surgery.
7 secondary outcomes
Change in homeostatic model assessment of insulin resistance (HOMA-IR)
Time frame: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in blood lipid profile
Time frame: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in blood pressure
Time frame: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in body mass index (BMI)
Time frame: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in grip strength
Time frame: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in mental well-being
Time frame: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Change in body fat percentage
Time frame: From baseline, to 1 week post-surgery and 7 weeks post-surgery.
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Mar 2020.
- Individual participant dataSharing planned: No. This is a small study which will generate pilot data for larger trials. Although the investigators will publish group data there is no plan to share individual data with other researchers. However, any requests for anonymised individual data will be considered on a case-by-case basis.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Niels BJ Vollaard, PhD principal investigator
University of Stirling
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Reduced-exertion, high-intensity interval training (REHIT) and Cognitive behavioral therapy (CBT) in people with Breast Cancer, run by University of Stirling at 1 site in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: withdrawn, as of the sponsor's last update on 25 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study was withdrawn before enrolling participants, so there are no results.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in maximal aerobic capacity (VO2max) (time frame: From baseline, to 1 week post-surgery and 7 weeks post-surgery.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Mar 2020.