Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan; Medical Oncology Unit, E.O. Ospedali Galliera, Genoa.
Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan.
Ann Oncol. 2011 Mar;22(3):582-587. doi: 10.1093/annonc/mdq427. Epub 2010 Aug 17.
Studies have shown that Ki-67 response after short-term neoadjuvant aromatase inhibitors may predict recurrence in postmenopausal breast cancer, whereas its prognostic effect in premenopausal women is unknown.
We compared the prognostic and predictive value of baseline and post-treatment Ki-67 in 120 pre- and postmenopausal women with early-stage estrogen receptor-positive breast cancer who participated in a 4-week presurgical trial of tamoxifen.
After 7.2 years of follow-up, women with post-treatment Ki-67 in the second (14%-19%), third (20%-29%) and top (≥30%) quartiles had a recurrence hazard ratio of 2.92 [95% confidence interval (CI) 0.95-8.96], 4.37 (1.56-12.25) and 6.05 (2.07-17.65), respectively, as compared with those in the bottom quartile (<14%) (P-trend = 0.001). The risk of invasive disease recurrence was 2.2% (95% CI 0.9-5.0) per point increase in baseline Ki-67 (P-trend = 0.076) and 5.0% (95% CI 2.3-7.7) per point increase in post-tamoxifen Ki-67 (P-trend < 0.001). The risk of death was 5.5 (95% CI 1.26-23.16) times higher in patients with post-drug Ki-67 ≥20% than in those with Ki-67 <20% (P-trend = 0.006).
Ki-67 response after short-term neoadjuvant tamoxifen is a good predictor of recurrence-free survival and overall survival, further supporting its use as surrogate biomarker to personalize adjuvant treatment and to screen novel drugs cost-effectively.
研究表明，短期新辅助芳香酶抑制剂治疗后 Ki-67 的反应可预测绝经后乳腺癌的复发，而其在绝经前妇女中的预后作用尚不清楚。
我们比较了 120 例接受短期术前他莫昔芬治疗的早期雌激素受体阳性乳腺癌的绝经前和绝经后妇女的基线和治疗后 Ki-67 的预后和预测价值。
在 7.2 年的随访后，治疗后 Ki-67 处于第二（14%-19%）、第三（20%-29%）和最高（≥30%）四分位数的女性复发风险比分别为 2.92（95%置信区间 [CI] 0.95-8.96）、4.37（1.56-12.25）和 6.05（2.07-17.65），与最低四分位数（<14%）（P 趋势=0.001）相比。基线 Ki-67 每增加 1 点，浸润性疾病复发的风险增加 2.2%（95%CI 0.9-5.0）（P 趋势=0.076），治疗后 Ki-67 每增加 1 点，浸润性疾病复发的风险增加 5.0%（95%CI 2.3-7.7）（P 趋势<0.001）。治疗后 Ki-67 ≥20%的患者比 Ki-67 <20%的患者死亡风险高 5.5 倍（95%CI 1.26-23.16）（P 趋势=0.006）。
短期新辅助他莫昔芬治疗后的 Ki-67 反应是无复发生存和总生存的良好预测指标，进一步支持其作为替代生物标志物用于个性化辅助治疗，并有效筛选新型药物。
