Abstract
Neoadjuvant chemotherapy (NCT) is one of the main treatment strategies for patients with locally advanced breast cancer. In this study, we focused on the predictive and prognostic value of Ki-67 in triple-negative breast cancer (TNBC) patients who received NCT. Data from 280 patients with stage II–III TNBC were collected. All patients were treated according to the same protocol with weekly paclitaxel and carboplatin. The overall pCR rate was 33.9%. Both the categorical and linear Ki-67 were independently correlated with pCR (P < 0.001). There were also statistically significant differences among Ki-67 categories with respect to clinical response (P < 0.001), Miller-Payne (MP) grades (P < 0.001), and node status (P < 0.001). A significant reduction of Ki-67 after NCT was most likely observed in patients with a relatively better response. In the multivariate model for non-pCR patients, Ki-67 reduction presented an independent prognostic value for relapse of disease (HR = 0.986, 95% CI: 0.978–0.994; P = 0.001). This study had indicated that the primary Ki-67 might help in further classifying TNBCs into subtypes with different responses to chemotherapy and a significant reduction of Ki-67 after treatment could indicate a favorable prognosis in non-pCR patients.
Highlights
Platinum agents, such as cisplatin and carboplatin, are DNA-damaging agents that have shown activity in breast cancer[14]
Positive CK5/6 expression was found in 57.1% of tumors, and positive epidermal growth factor receptor (EGFR) expression was found in 53.5% of tumors
The hazard ratios (HRs) of the Ki-67 tertiles were 2.490 for the median-level Ki-67 tertile and 8.738 for the high-level Ki-67 tertile, with the low-level Ki-67 tertile used as a reference
Summary
Platinum agents, such as cisplatin and carboplatin, are DNA-damaging agents that have shown activity in breast cancer[14]. This study was designed to demonstrate the utility of a platinum-containing treatment regimen in the neoadjuvant setting and to identify the predictive or prognostic value of Ki-67 among patients with TNBC. There were statistically significant differences among the low-level, median-level, and high-level Ki-67 groups with respect to the clinical response (P < 0.001), MP grades (P < 0.001), and node status (P < 0.001).
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