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01-06-2019 | Breast Cancer | Clinical Trial

Prognostic effect of Ki-67 in common clinical subgroups of patients with HER2-negative, hormone receptor-positive early breast cancer

Authors: Peter A. Fasching, Paul Gass, Lothar Häberle, Bernhard Volz, Alexander Hein, Carolin C. Hack, Michael P. Lux, Sebastian M. Jud, Arndt Hartmann, Matthias W. Beckmann, Dennis J. Slamon, Ramona Erber

Published in: Breast Cancer Research and Treatment | Issue 3/2019

Abstract

Purpose

Several clinical trials have investigated the prognostic and predictive usefulness of molecular markers. With limited predictive value, molecular markers have mainly been used to identify prognostic subgroups in which the indication for chemotherapy is doubtful and the prognosis is favorable enough for chemotherapy to be avoided. However, limited information is available about which groups of patients may benefit from additional therapy. This study aimed to describe the prognostic effects of Ki-67 in several common subgroups of patients with early breast cancer.

Methods

This retrospective study analyzed a single-center cohort of 3140 patients with HER2−, hormone receptor-positive breast cancer. Five-year disease-free survival (DFS) rates were calculated for low (< 10%), intermediate (10–19%), and high (≥ 20%) Ki-67 expression levels, as assessed by immunohistochemistry, and for subgroups relative to age, body mass index, disease stage, tumor grade, and (neo-)adjuvant chemotherapy. It was also investigated whether Ki-67 had different effects on DFS in these subgroups.

Results

The 5-year DFS rates for patients with low, intermediate, and high levels of Ki-67 expression were 0.90, 0.89, and 0.77, respectively. Ki-67 was able to further differentiate patients with an intermediate prognosis into different prognostic groups relative to common clinical parameters. Patients with stage II breast cancer had 5-year DFS rates of 0.84, 0.88, and 0.79 for low, intermediate, and high levels of Ki-67 expression. Ki-67 had different prognostic effects in subgroups defined by age and tumor grade.

Conclusions

Ki-67 may help identify patients in intermediate prognostic groups with an unfavorable prognosis who may benefit from further therapy.

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Title: Prognostic effect of Ki-67 in common clinical subgroups of patients with HER2-negative, hormone receptor-positive early breast cancer
Authors: Peter A. Fasching
Paul Gass
Lothar Häberle
Bernhard Volz
Alexander Hein
Carolin C. Hack
Michael P. Lux
Sebastian M. Jud
Arndt Hartmann
Matthias W. Beckmann
Dennis J. Slamon
Ramona Erber
Publication date: 01-06-2019
Publisher: Springer US
Keywords: Breast Cancer
Breast Cancer
Cytostatic Therapy
Published in: Breast Cancer Research and Treatment / Issue 3/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-019-05198-9

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