RT Journal Article
T1 High Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer.
A1 Alba, Emilio
A1 Lluch, Ana
A1 Ribelles, Nuria
A1 Anton-Torres, Antonio
A1 Sanchez-Rovira, Pedro
A1 Albanell, Joan
A1 Calvo, Lourdes
A1 García-Asenjo, Jose Antonio Lopez
A1 Palacios, Jose
A1 Chacon, Jose Ignacio
A1 Ruiz, Amparo
A1 De la Haba-Rodriguez, Juan
A1 Segui-Palmer, Miguel A
A1 Cirauqui, Beatriz
A1 Margeli, Mireia
A1 Plazaola, Arrate
A1 Barnadas, Agusti
A1 Casas, Maribel
A1 Caballero, Rosalia
A1 Carrasco, Eva
A1 Rojo, Federico
K1 Breast cancer
K1 Chemosensitivity
K1 Ki67
K1 Neoadjuvant chemotherapy
K1 Predictive factor
AB In 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.
YR 2016
FD 2016-01-19
LK http://hdl.handle.net/10668/9746
UL http://hdl.handle.net/10668/9746
LA en
DS RISalud
RD Apr 6, 2025