High Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer
Por:
Alba, E, Lluch, A, Ribelles, N, Anton-Torres, A, Sanchez-Rovira, P, Albanell, J, Calvo, L, Garcia-Asenjo, JAL, Palacios, J, Chacon, JI, Ruiz, A, De la Haba-Rodriguez, J, Segui-Palmer, MA, Cirauqui, B, Margeli, M, Plazaola, A, Barnadas, A, Casas, M, Caballero, R, Carrasco, E, Rojo, F
Publicada:
1 feb 2016
Resumen:
Background. 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.
Patients and Methods. 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).
Results. 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%.
Conclusion. 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.
Filiaciones:
Alba, E:
Virgen de la Victoria Univ Hosp, Malaga, Spain
Lluch, A:
Valencia Univ Hosp, Valencia, Spain
Ribelles, N:
Virgen de la Victoria Univ Hosp, Malaga, Spain
Anton-Torres, A:
Miguel Servet Univ Hosp, Zaragoza, Spain
Sanchez-Rovira, P:
Jaen Hosp Complex, Jaen, Spain
Albanell, J:
Inst Hosp del Mar Invest Med, Hosp del Mar, Med Res Inst, Barcelona, Spain
Pompeu Fabra Univ, Barcelona, Spain
Calvo, L:
A Coruna Univ Hosp Complex, La Coruna, Spain
Garcia-Asenjo, JAL:
San Carlos Univ Hospial, Madrid, Spain
Palacios, J:
Ramon y Cajal Univ Hosp, Madrid, Spain
Chacon, JI:
Virgen de la Salud Hosp, Toledo, Spain
Ruiz, A:
Valencian Inst Oncol, Valencia, Spain
De la Haba-Rodriguez, J:
Reina Sofia Hosp Complex, Biomed Res Inst, Cordoba, Spain
Segui-Palmer, MA:
Parc Tauli Hlth Corp, Barcelona, Spain
Cirauqui, B:
Germans Trias & Pujol Univ Hosp, Barcelona, Spain
Margeli, M:
Germans Trias & Pujol Univ Hosp, Barcelona, Spain
Plazaola, A:
Onkologikoa, Donostia San Sebastian, Spain
Barnadas, A:
Santa Creu & St Pau Hosp, Barcelona, Spain
Casas, M:
GEICAM Spanish Breast Canc Res Grp, Madrid, Spain
Caballero, R:
GEICAM Spanish Breast Canc Res Grp, Madrid, Spain
Carrasco, E:
GEICAM Spanish Breast Canc Res Grp, Madrid, Spain
Rojo, F:
Fdn Jimenez Diaz Univ Hosp, Madrid, Spain
Bronze, Green Published
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