Clinical significance of Ki-67 in neoadjuvant chemotherapy for primary breast cancer as a predictor for chemosensitivity and for prognosis View Full Text


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Article Info

DATE

2009-09-04

AUTHORS

Reiki Nishimura, Tomofumi Osako, Yasuhiro Okumura, Mitsuhiro Hayashi, Nobuyuki Arima

ABSTRACT

BackgroundNeoadjuvant chemotherapy (NAC) is one of the main strategies for patients with locally advanced breast cancer. In recent years several biological markers such as estrogen receptor (ER), progesterone receptor (PgR), and HER2 were discovered to be predictive factors for the effectiveness of NAC to help individualize treatment. In this retrospective study, we focused on Ki-67 as a biological marker and examined the correlation between Ki-67 and chemosensitivity, and the prognosis after the start of treatment.Patients and methodsBetween July 1996 and March 2008, 148 patients with tumors ≥3 cm in diameter or lymph node metastases received NAC and surgery. The items investigated were ER/PgR and Ki-67 from core needle biopsy. The treatment regimens were EC in 36 cases, ET in 51 cases, and FEC-DOC in 61 cases. The patients with FEC-DOC regimen had smaller tumors and higher Ki-67 values than the others.ResultsClinical response (cCR + cPR) was 79.7%, and the pathological complete response (pCR) was 14.2%. Multivariate analysis revealed that Ki-67 was significantly related to pCR. Moreover, there was no pathological responder in cases with Ki-67 < 25%. The Ki-67 values significantly decreased after NAC (median from 45.0 to 17.5%). Patients with cCR had significantly lower Ki-67 values after NAC than those with cPR, cSD, and cPD. There was a significant difference in the Ki-67 value in terms of the presence and the absence of recurrence (median 26.0% with recurrence vs. 12% without recurrence). The disease-free survival (DFS) rate after the start of treatment was significantly higher in the patients with Ki-67 < 12% after NAC than those with Ki-67 ≥ 12%.ConclusionThe Ki-67 value before NAC was a significant predictive factor for the effectiveness of NAC. The Ki-67 values after NAC significantly decreased and correlated with clinical response and DFS. Therefore, higher Ki-67 values (≥25%) before NAC as well as lower values (<12%) after NAC might be clinically significant for treating patients. More... »

PAGES

269-275

References to SciGraph publications

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    http://scigraph.springernature.com/pub.10.1007/s12282-009-0161-5

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    http://dx.doi.org/10.1007/s12282-009-0161-5

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    https://www.ncbi.nlm.nih.gov/pubmed/19730975


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    47 schema:description BackgroundNeoadjuvant chemotherapy (NAC) is one of the main strategies for patients with locally advanced breast cancer. In recent years several biological markers such as estrogen receptor (ER), progesterone receptor (PgR), and HER2 were discovered to be predictive factors for the effectiveness of NAC to help individualize treatment. In this retrospective study, we focused on Ki-67 as a biological marker and examined the correlation between Ki-67 and chemosensitivity, and the prognosis after the start of treatment.Patients and methodsBetween July 1996 and March 2008, 148 patients with tumors ≥3 cm in diameter or lymph node metastases received NAC and surgery. The items investigated were ER/PgR and Ki-67 from core needle biopsy. The treatment regimens were EC in 36 cases, ET in 51 cases, and FEC-DOC in 61 cases. The patients with FEC-DOC regimen had smaller tumors and higher Ki-67 values than the others.ResultsClinical response (cCR + cPR) was 79.7%, and the pathological complete response (pCR) was 14.2%. Multivariate analysis revealed that Ki-67 was significantly related to pCR. Moreover, there was no pathological responder in cases with Ki-67 < 25%. The Ki-67 values significantly decreased after NAC (median from 45.0 to 17.5%). Patients with cCR had significantly lower Ki-67 values after NAC than those with cPR, cSD, and cPD. There was a significant difference in the Ki-67 value in terms of the presence and the absence of recurrence (median 26.0% with recurrence vs. 12% without recurrence). The disease-free survival (DFS) rate after the start of treatment was significantly higher in the patients with Ki-67 < 12% after NAC than those with Ki-67 ≥ 12%.ConclusionThe Ki-67 value before NAC was a significant predictive factor for the effectiveness of NAC. The Ki-67 values after NAC significantly decreased and correlated with clinical response and DFS. Therefore, higher Ki-67 values (≥25%) before NAC as well as lower values (<12%) after NAC might be clinically significant for treating patients.
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    54 schema:keywords BackgroundNeoadjuvant chemotherapy
    55 CCR
    56 CPD
    57 CPR
    58 CSD
    59 DFS
    60 EC
    61 ER/PgR
    62 HER2
    63 Ki-67
    64 Ki-67 values
    65 NAC
    66 PgR
    67 ResultsClinical response
    68 absence
    69 absence of recurrence
    70 advanced breast cancer
    71 analysis
    72 biological markers
    73 biopsy
    74 breast cancer
    75 cancer
    76 cases
    77 chemosensitivity
    78 chemotherapy
    79 clinical response
    80 clinical significance
    81 complete response
    82 core needle biopsy
    83 correlation
    84 diameter
    85 differences
    86 disease-free survival rates
    87 effectiveness
    88 effectiveness of NAC
    89 estrogen receptor
    90 et
    91 factors
    92 higher Ki-67 values
    93 items
    94 low Ki-67 values
    95 lower values
    96 lymph node metastasis
    97 main strategies
    98 markers
    99 metastasis
    100 multivariate analysis
    101 needle biopsy
    102 neoadjuvant chemotherapy
    103 node metastasis
    104 pathological complete response
    105 pathological responders
    106 patients
    107 predictive factors
    108 predictors
    109 presence
    110 primary breast cancer
    111 progesterone receptor
    112 prognosis
    113 rate
    114 recent years
    115 receptors
    116 recurrence
    117 regimen
    118 regimens
    119 responders
    120 response
    121 retrospective study
    122 significance
    123 significant differences
    124 significant predictive factors
    125 small tumors
    126 start
    127 start of treatment
    128 strategies
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    131 survival rate
    132 terms
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