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

• Published in: Breast cancer (Tokyo, Japan) Japan), 2010-10, Vol.17 (4), p.269-275
• Main Authors: Nishimura, Reiki, Osako, Tomofumi, Okumura, Yasuhiro, Hayashi, Mitsuhiro, Arima, Nobuyuki
• Format: Article
• Language: English
• Subjects: Adjuvant treatment; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - pharmacology; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Aromatase Inhibitors - administration & dosage; Biomarkers - metabolism; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - metabolism; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Cancer; Cancer patients; Cancer Research; Cell Proliferation - drug effects; Cyclophosphamide - administration & dosage; Drug Resistance, Neoplasm; Epirubicin - administration & dosage; Estrogen; Etoposide - administration & dosage; Female; Fluorouracil - administration & dosage; Humans; Ki-67 Antigen - metabolism; Logistic Models; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Multivariate Analysis; Neoadjuvant Therapy; Oncology; Original Article; Progesterone; Prognosis; Receptor, ErbB-2 - metabolism; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Retrospective Studies; Surgery; Surgical Oncology; Survival Analysis; Tamoxifen - administration & dosage; Taxoids - administration & dosage; Tumor Suppressor Protein p53 - metabolism
• ISSN: 1340-6868; 1880-4233
• DOI: 10.1007/s12282-009-0161-5

Background Neoadjuvant 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 methods Between 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. Results Clinical 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