- Volume 17 Issue 2
DOI QR Code
Response of Triple Negative Breast Cancer to Neoadjuvant Chemotherapy: Correlation between Ki-67 Expression and Pathological Response
- Elnemr, Gamal M (Department of Internal Medicine, Faculty of Medicine, Taif University) ;
- El-Rashidy, Ahmed H (Department of Pathology, Faculty of Medicine, Al-Azhar University (Assuit Branch)) ;
- Osman, Ahmed H (Department of Pathology, Faculty of Medicine, Taif University) ;
- Issa, Lotfi F (Department of Community Medicine, Faculty of Medicine, Al-Azhar University) ;
- Abbas, Osama A (Department of Clinical Oncology, Faculty of Medicine, Ain-Shams University) ;
- Al-Zahrani, Abdullah S (Oncology Center, King Abdullah Medical City, Holly Capital) ;
- El-Seman, Sheriff M (Oncology Center, King Abdullah Medical City, Holly Capital) ;
- Mohammed, Amrallah A (Department of Medical Oncology, Faculty of Medicine, Zagagzig University) ;
- Hassan, Abdelghani A (Department of Physiology, Faculty of Medicine, Taif University)
- Published : 2016.03.07
Triple-negative breast cancers constitute about 15% of all cases, but despite their higher response to neoadjuvant chemotherapy, the tumors are very aggressive and associated with a poor prognosis as well as a higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III invasive breast cancer who received 6-8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the triple negative breast cancer subgroup. Nuclear Ki-67 expression in both the large cohort group (n=101) and triple negative breast cancer subgroup (n=23) and its relation to the pathological response were evaluated. The purpose of the study was to identify the predictive value of nuclear protein Ki-67 expression among patients with invasive breast cancers, involving the triple negative breast cancer subgroup, treated with neoadjuvant chemotherapy in correlation to the rate of pathological complete response. The proliferation marker Ki-67 expression was highest in the triple negative breast cancer subgroup. No appreciable difference in the rate of Ki-67 expression in triple negative breast cancer subgroup using either a cutoff of 14% or 35%. Triple negative breast cancer subgroup showed lower rates of pathological complete response. Achievement of pathological complete response was significantly correlated with smaller tumor size and higher Ki-67 expression. The majority of triple negative breast cancer cases achieved pathological partial response. The study concluded that Ki-67 is a useful tool to predict chemosensitivity in the setting of neoadjuvant chemotherapy for invasive breast cancer but not for the triple negative breast cancer subgroup.
- Anders CK, Carey LA (2009). Biology, metastatic patterns, and treatment of patients with triple-negative breast cancer. Clinical Breast Cancer, 9, 73-81. https://doi.org/10.3816/CBC.2009.s.008
- Andre F, Zielinski C (2012). Optimal strategies for the treatment of metastatic triple-negative breast cancer with currently approved agents. Ann Oncology, 23, 46-51. https://doi.org/10.1093/annonc/mdr047
- Aysola K, Desai A, Welch C, et al (2013). Triple negative breast cancer-an overview. Hereditary Genetics: Current Research, 2013.
- Berrada N, Delaloge S, Andre F (2010). Treatment of triplenegative metastatic breast cancer: toward individualized targeted treatments or chemosensitization? Ann Oncol, 21, 30-5. https://doi.org/10.1093/annonc/mdq279
- Bidard F-C, Matthieu M-C, Chollet P, et al (2008). p53 status and efficacy of primary anthracyclines/alkylating agent-based regimen according to breast cancer molecular classes. Ann Oncol, 19, 1261-5. https://doi.org/10.1093/annonc/mdn039
- Burstein HJ, Harris JR, Morrow M (2008). Malignant tumors of the breast. Cancer: principles and practice of oncology. 8th ed. Philadelphia: Lippincott, Williams & Wilkins, 1606-54.
- Edge SB, Byrd DR, Compton CC, et al (2010). AJCC cancer staging manual, Springer New York.
- Gerdes J, Li L, Schlueter C, et al (1991). Immunobiochemical and molecular biologic characterization of the cell proliferation-associated nuclear antigen that is defined by monoclonal antibody Ki-67. Am J Pathol, 138, 867.
- Gluz O, Liedtke C, Gottschalk N, et al (2009). Triple-negative breast cancer-current status and future directions. Ann Oncol, 492.
- Inwald E, Klinkhammer-Schalke M, Hofstädter F, et al (2013). Ki-67 is a prognostic parameter in breast cancer patients:results of a large population-based cohort of a cancer registry. Breast Cancer Res Treatment, 139, 539-52. https://doi.org/10.1007/s10549-013-2560-8
- Keam B, Im S-A, Lee K-H, et al (2011). Ki-67 can be used for further classification of triple negative breast cancer into two subtypes with different response and prognosis. Breast Cancer Res, 13, 22.
- Liedtke C, Mazouni C, Hess KR, et al (2008). Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. J Clin Oncol, 26, 1275-81. https://doi.org/10.1200/JCO.2007.14.4147
- Liu M, Mo QG, Wei CY, et al (2013). Platinum‑based chemotherapy in triple‑negative breast cancer: A meta‑analysis. Oncology letters, 5, 983-91. https://doi.org/10.3892/ol.2012.1093
- Luporsi E, Andre F, Spyratos F, et al (2012). Ki-67: level of evidence and methodological considerations for its role in the clinical management of breast cancer: analytical and critical review. Breast Cancer Res Treatment, 132, 895-915. https://doi.org/10.1007/s10549-011-1837-z
- Masuda H, Baggerly KA, Wang Y, et al (2013). Differential pathologic complete response rates after neoadjuvant chemotherapy among molecular subtypes of triple-negative breast cancer. ASCO Annual Meeting Proc, 1005.
- Mayer IA, Abramson VG, Lehmann BD, et al (2014). New strategies for triple-negative breast cancer-deciphering the heterogeneity. Clinical Cancer Res, 20, 782-90. https://doi.org/10.1158/1078-0432.CCR-13-0583
- Milde-Langosch K, Karn T, Muller V, et al (2013). Validity of the proliferation markers Ki67, TOP2A, and RacGAP1 in molecular subgroups of breast cancer. Breast Cancer Res Treatment, 137, 57-67. https://doi.org/10.1007/s10549-012-2296-x
- Peddi PF, Ellis MJ, Ma C (2011). Molecular basis of triple negative breast cancer and implications for therapy. Int J Breast Cancer, 2012.
- Rocca A, Viale G, Gelber RD, et al (2008). Pathologic complete remission rate after cisplatin-based primary chemotherapy in breast cancer: correlation with p63 expression. Cancer Chemotherapy Pharmacol, 61, 965-71. https://doi.org/10.1007/s00280-007-0551-3
- Silver DP, Richardson AL, Eklund AC, et al (2010). Efficacy of neoadjuvant Cisplatin in triple-negative breast cancer. J Clin Oncol, 28, 1145-53. https://doi.org/10.1200/JCO.2009.22.4725
- Sorlie T, Perou CM, Tibshirani R, et al (2001). Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA, 98, 10869-74. https://doi.org/10.1073/pnas.191367098
- Von Minckwitz G, Martin M (2012). Neoadjuvant treatments for triple-negative breast cancer (TNBC). Ann Oncol, 23, 35-9.
- Yerushalmi R, Woods R, Ravdin PM, et al (2010). Ki67 in breast cancer: prognostic and predictive potential. Lancet Oncol, 11, 174-83. https://doi.org/10.1016/S1470-2045(09)70262-1
- The predictive value of Ki-67 before neoadjuvant chemotherapy for breast cancer: a systematic review and meta-analysis vol.13, pp.9, 2017, https://doi.org/10.2217/fon-2016-0420
- Ki-67 labeling index is a predictive marker for a pathological complete response to neoadjuvant chemotherapy in breast cancer vol.96, pp.51, 2017, https://doi.org/10.1097/MD.0000000000009384
- Impact of Topoisomerase IIα, PTEN, ABCC1/MRP1, and KI67 on triple-negative breast cancer patients treated with neoadjuvant chemotherapy pp.1573-7217, 2018, https://doi.org/10.1007/s10549-018-4985-6
- OCT4 but not SOX2 expression correlates with worse prognosis in surgical patients with triple-negative breast cancer vol.25, pp.4, 2018, https://doi.org/10.1007/s12282-018-0844-x