Evaluation of ER and Ki-67 proliferation index as prognostic factors for survival following neoadjuvant chemotherapy with doxorubicin/docetaxel for locally advanced breast cancer |
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Authors: | J Lee Y H Im S H Lee E Y Cho Y L Choi Y H Ko J H Kim S J Nam H J Kim J S Ahn Y S Park H Y Lim B K Han J H Yang |
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Institution: | (1) Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, South Korea;(2) Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;(3) Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;(4) Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea |
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Abstract: | Background The aim of the study was to identify reliable predictive biological markers for treatment outcome following neoadjuvant adriamycin/docetaxel
(AT) chemotherapy in locally advanced breast cancer patients.
Materials and methods This study was a phase II study on AT neoadjuvant chemotherapy in locally advanced breast cancer patients. Patients received
50 mg/m2 of doxorubicin intravenously (IV) over 15 min followed by docetaxel 75 mg/m2 infused over 1 h, repeated every 3 weeks for three cycles. Surgery was performed within 3–4 weeks following the last cycle
of chemotherapy. We analyzed the pre-treatment and post-treatment expression levels of ER, PgR, HER-2, Ki-67 proliferation
index, and p53 and examined the correlation between the markers and clinical parameters with treatment response, overall survival
and relapse-free survival following neoadjuvant treatment.
Results From July 2001 to September 2004, 61 patients were enrolled. The meaningful parameters adversely influencing survival were
post-treatment ER(−) status (P = 0.013) and post-treatment Ki-67 index above 1.0% (P = 0.013). At the multivariate level, the post-treatment Ki-67 proliferation index ≤ 1.0 was the only meaningful prognostic
factor for better survival (P = 0.033). Notably, tumors with Ki-67 index ≤ 1.0 were more likely to express ER with statistical significance (P = 0.002). Tumors with ER(+) and Ki-67 index ≤ 1.0 showed the highest survival rate, followed by ER(+) and Ki-67 index > 1.0%,
ER(−) and Ki-67 ≤ 1.0%, and ER(−) and Ki-67 > 1.0% with the worst survival (P = 0.033).
Conclusion Collectively, post-treatment ER status and Ki-67 proliferation index were prognostic of overall survival following neoadjuvant
AT chemotherapy. |
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Keywords: | Ki-67 proliferation index Breast cancer Neoadjuvant chemotherapy |
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