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High Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer.

dc.contributor.authorAlba, Emilio
dc.contributor.authorLluch, Ana
dc.contributor.authorRibelles, Nuria
dc.contributor.authorAnton-Torres, Antonio
dc.contributor.authorSanchez-Rovira, Pedro
dc.contributor.authorAlbanell, Joan
dc.contributor.authorCalvo, Lourdes
dc.contributor.authorLopez-Garcia-Asenjo, Jose Antonio
dc.contributor.authorPalacios, Jose
dc.contributor.authorChacon, Jose Ignacio
dc.contributor.authorRuiz, Amparo
dc.contributor.authorDe la Haba-Rodriguez, Juan
dc.contributor.authorSegui-Palmer, Miguel A
dc.contributor.authorCirauqui, Beatriz
dc.contributor.authorMargeli, Mireia
dc.contributor.authorPlazaola, Arrate
dc.contributor.authorBarnadas, Agusti
dc.contributor.authorCasas, Maribel
dc.contributor.authorCaballero, Rosalia
dc.contributor.authorCarrasco, Eva
dc.contributor.authorRojo, Federico
dc.contributor.funderFondo Europeo de Desarrollo Regional
dc.contributor.funderRetics Biobank
dc.contributor.funderISCIII
dc.date.accessioned2023-01-25T08:30:38Z
dc.date.available2023-01-25T08:30:38Z
dc.date.issued2016-01-19
dc.description.abstractIn the neoadjuvant setting, changes in the proliferation marker Ki67 are associated with primary endocrine treatment efficacy, but its value as a predictor of response to chemotherapy is still controversial. We analyzed 262 patients with centralized basal Ki67 immunohistochemical evaluation derived from 4 GEICAM (Spanish Breast Cancer Group) clinical trials of neoadjuvant chemotherapy for breast cancer. The objective was to identify the optimal threshold for Ki67 using the receiver-operating characteristic curve method to maximize its predictive value for chemotherapy benefit. We also evaluated the predictive role of the defined Ki67 cutoffs for molecular subtypes defined by estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2). A basal Ki67 cutpoint of 50% predicted pathological complete response (pCR). Patients with Ki67 >50% achieved a pCR rate of 40% (36 of 91) versus a pCR rate of 19% in patients with Ki67 ≤ 50% (33 of 171) (p = .0004). Ki67 predictive value was especially relevant in ER-HER2- and ER-HER2+ patients (pCR rates of 42% and 64%, respectively, in patients with Ki67 >50% versus 15% and 45%, respectively, in patients with Ki67 ≤ 50%; p = .0337 and .3238, respectively). Both multivariate analyses confirmed the independent predictive value of the Ki67 cutpoint of 50%. Basal Ki67 proliferation index >50% should be considered an independent predictive factor for pCR reached after neoadjuvant chemotherapy, suggesting that cell proliferation is a phenomenon closely related to chemosensitivity. These findings could help to identify a group of patients with a potentially favorable long-term prognosis. The use of basal Ki67 status as a predictive factor of chemotherapy benefit could facilitate the identification of a patient subpopulation with high probability of achieving pathological complete response when treated with primary chemotherapy, and thus with a potentially favorable long-term prognosis.
dc.description.sponsorshipThis work was supported by funds from Fondo Europeo de Desarrollo Regional (RedTematica deInvestigacion Cooperativa en Cancer): D12/0036/0076 (J.A. and A.B.), RD12/0036/0051 (J.A. and J.R.), RD12/0036/0070 (A.L.), and Retics Biobank RD/09/0076/00101 (F.R.). J.A. and F.R. are recipients of intensification grant ISCIII.R
dc.description.versionSi
dc.identifier.citationAlba E, Lluch A, Ribelles N, Anton-Torres A, Sanchez-Rovira P, Albanell J, et al. High Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer. Oncologist. 2016 Feb;21(2):150-5
dc.identifier.doi10.1634/theoncologist.2015-0312
dc.identifier.essn1549-490X
dc.identifier.pmcPMC4746087
dc.identifier.pmid26786263
dc.identifier.pubmedURLhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746087/pdf
dc.identifier.unpaywallURLhttps://theoncologist.onlinelibrary.wiley.com/doi/pdfdirect/10.1634/theoncologist.2015-0312
dc.identifier.urihttp://hdl.handle.net/10668/9746
dc.issue.number2
dc.journal.titleThe oncologist
dc.journal.titleabbreviationOncologist
dc.language.isoen
dc.organizationHospital Universitario Reina Sofía
dc.organizationHospital Universitario de Jaén
dc.organizationHospital Universitario Virgen de la Victoria
dc.page.number150-5
dc.provenanceRealizada la curación de contenido 11/08/2025
dc.publisherOxford University Press
dc.pubmedtypeJournal Article
dc.pubmedtypeResearch Support, Non-U.S. Gov't
dc.relation.projectIDRD12/0036/0076
dc.relation.projectIDRD12/0036/0051
dc.relation.projectIDRD12/0036/0070
dc.relation.projectIDRD/09/0076/00101
dc.relation.publisherversionhttps://academic.oup.com/oncolo/article-lookup/doi/10.1634/theoncologist.2015-0312
dc.rights.accessRightsRestricted Access
dc.subjectBreast cancer
dc.subjectChemosensitivity
dc.subjectKi67
dc.subjectNeoadjuvant chemotherapy
dc.subjectPredictive factor
dc.subject.decsÍndice de proliferación celular Ki‑67
dc.subject.decsQuimioterapia neoadyuvante
dc.subject.decsRespuesta patológica completa
dc.subject.decsCáncer de mama
dc.subject.decsSubtipos moleculares de neoplasia mamaria
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshBreast Neoplasms
dc.subject.meshClinical Trials as Topic
dc.subject.meshDisease-Free Survival
dc.subject.meshEstrogen Receptor alpha
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshKi-67 Antigen
dc.subject.meshMiddle Aged
dc.subject.meshNeoadjuvant Therapy
dc.subject.meshNeoplasm Staging
dc.subject.meshPredictive Value of Tests
dc.subject.meshPrognosis
dc.subject.meshReceptor, ErbB-2
dc.titleHigh Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer.
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number21
dspace.entity.typePublication

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