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Prognostic significance of pathologic complete response and Ki67 expression after neoadjuvant chemotherapy in breast cancer
| Title: | Prognostic significance of pathologic complete response and Ki67 expression after neoadjuvant chemotherapy in breast cancer |
| Authors: | Yoshioka, Tatsuya Browse this author | | Hosoda, Mitsuchika Browse this author →KAKEN DB | | Yamamoto, Mitsugu Browse this author | | Taguchi, Kazunori Browse this author | | Hatanaka, Kanako C. Browse this author | | Takakuwa, Emi Browse this author | | Hatanaka, Yutaka Browse this author →KAKEN DB | | Matsuno, Yoshihiro Browse this author | | Yamashita, Hiroko Browse this author →KAKEN DB |
| Keywords: | Breast cancer | | Neoadjuvant chemotherapy | | Pathologic complete response | | Ki67 |
| Issue Date: | Mar-2015 |
| Publisher: | Springer Japan Kk |
| Journal Title: | Breast Cancer |
| Volume: | 22 |
| Issue: | 2 |
| Start Page: | 185 |
| End Page: | 191 |
| Publisher DOI: | 10.1007/s12282-013-0474-2 |
| PMID: | 23645542 |
| Abstract: | Recent studies have indicated that response to chemotherapy and the prognostic impact of a pathologic complete response (pCR) after neoadjuvant chemotherapy differ among breast cancer subtypes. Women with Stage I to III breast cancer treated with anthracycline and taxane-based neoadjuvant chemotherapy (four cycles of docetaxel every 3 weeks followed by four cycles of FEC every 3 weeks) between 2006 and 2011 were retrospectively analyzed. Trastuzumab was concurrently added to docetaxel for HER2-positive breast cancer. Expression of estrogen receptor (ER), progesterone receptor (PgR), HER2, and Ki67 was examined by immunohistochemistry in pre- and post-treatment specimens. Predictive factors for neoadjuvant chemotherapy and prognosis were analyzed by breast cancer subtype. Of 64 patients, 30 (47 %) were ER-positive (ER+) HER2-negative (HER2-), including eight as luminal A (Ki67 labeling index (LI) < 14 %) and 22 as luminal B (Ki67 LI a parts per thousand yen 14 %) subtypes, 11 (17 %) were ER+ HER2-positive (HER2+), 12 (19 %) were ER-negative (ER-) HER2+, and 11 (17 %) were ER- HER2-. The clinical response rates were significantly higher in luminal B, ER+ HER2+, and ER- HER2+ subtypes compared with luminal A subtype. Patients whose tumors contained high Ki67 expression effectively responded to neoadjuvant chemotherapy. Ki67 LI was a predictive marker for pCR, and all patients whose tumors achieved pCR are currently disease-free. Furthermore, high Ki67 expression in post-treatment tumors was strongly correlated with poor disease-free and overall survival regardless of subtype. It is necessary to establish additional strategies to improve survival for patients whose residual tumors show high Ki67 expression after neoadjuvant chemotherapy. |
| Rights: | The final publication is available at link.springer.com |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/60736 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 山下 啓子
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