Ki-67 index after neoadjuvant endocrine therapy as a prognostic biomarker in patients with ER-positive/HER2-negative early breast cancer: a systematic review and meta-analysis

Martins-Branco, Diogo; Nader-Marta, Guilherme; Molinelli, Chiara; Ameye, Lieveke; Paesmans, Marianne; Ignatiadis, Michail; Aftimos, Philippe; Salgado, Roberto; de Azambuja, Evandro

doi:10.1016/j.ejca.2023.113358

Cited by 4 publications

(2 citation statements)

References 38 publications

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“…Furthermore, the tumor’s Ki67 index remained untouched at 30% from the diagnostic biopsy to the surgical specimen. A high Ki67 index after neoadjuvant endocrine therapy is known to be a strong prognostic biomarker, being associated with worse recurrence-free survival and overall survival ( 28 ). Another interesting aspect in this case is the progesterone receptor downregulation following ET exposure, suggesting an in vivo selection of potentially ET-resistant clones.…”

Section: Discussionmentioning

confidence: 99%

Case report: Primary CDK4/6 inhibitor and endocrine therapy in locally advanced breast cancer and its effect on gut and intratumoral microbiota

Vilhais,

Alpuim Costa,

Fontes-Sousa

et al. 2024

Front. Oncol.

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Locally advanced breast cancer poses significant challenges to the multidisciplinary team, in particular with hormone receptor (HR) positive, HER2-negative tumors that classically yield lower pathological complete responses with chemotherapy. The increasingly significant use of CDK 4/6 inhibitors (CDK4/6i) plus endocrine therapy (ET) in different breast cancer settings has led to clinical trials focusing on this strategy as a primary treatment, with promising results. The impact of the microbiota on cancer, and vice-versa, is an emerging topic in oncology. The authors report a clinical case of a postmenopausal female patient with an invasive breast carcinoma of the right breast, Luminal B-like, staged as cT4cN3M0 (IIIB). Since the lesion was considered primarily inoperable, the patient started letrozole and ribociclib. Following 6 months of systemic therapy, the clinical response was significant, and surgery with curative intent was performed. The final staging was ypT3ypN2aM0, R1, and the patient started adjuvant letrozole and radiotherapy. This case provides important insights on primary CDK4/6i plus ET in locally advanced unresectable HR+/HER2- breast cancer and its potential implications in disease management further ahead. The patient’s gut microbiota was analyzed throughout the disease course and therapeutic approach, evidencing a shift in gut microbial dominance from Firmicutes to Bacteroidetes and a loss of microbial diversity following 6 months of systemic therapy. The analysis of the intratumoral microbiota from the surgical specimen revealed high microbial dissimilarity between the residual tumor and respective margins.

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Section: Discussionmentioning

confidence: 99%

Case report: Primary CDK4/6 inhibitor and endocrine therapy in locally advanced breast cancer and its effect on gut and intratumoral microbiota

Vilhais,

Alpuim Costa,

Fontes-Sousa

et al. 2024

Front. Oncol.

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“…As a cellular marker of proliferation, it can be detected within the cell nucleus of proliferating cells, whereas its expression is absent in quiescent cells (G 0 -phase) [11]. It is reported to be prognostic in a number of different malignancies such as non-small cell lung cancer, colon cancer and breast cancer [22,23]. A high Ki67 expression and therefore a high proliferation index is a sign of tumor aggressiveness and tumor growth [11,17].…”

Section: Introductionmentioning

confidence: 99%

Ki67 Tumor Expression Predicts Treatment Benefit Achieved by Macroscopic Radical Lung-Preserving Surgery in Pleural Mesothelioma—A Retrospective Multicenter Analysis

Hintermair,

Iser,

Varga

et al. 2024

Cancers

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Pleural mesothelioma (PM), linked to asbestos-induced inflammation, carries a poor prognosis. Therapy ranges from therapy limitation to aggressive multimodality treatment. Given the uncertainty about treatment benefits for patients, this study aimed to assess the role of Ki67 as a prognostic and predictive parameter in PM. Ki67 was measured in the specimens of 70 PM patients (17 female, 53 male) from two centers and correlated to overall survival (OS) and therapy outcome. The median OS was 16.1 months. The level of Ki67 expression was divided into low (≤15%) and high (>15%). A low value of Ki67 expression was associated with a longer OS (Ki67 ≤ 15%: 31.2 (95% CI 6.5–55.8) months vs. Ki67 > 15%: 11.1 (95% CI 7.7–14.6) months, p = 0.012). The 5-year survival represents 22% in the low Ki67 expression group, in contrast to 5% in the high Ki67 expression group. We found a significant interaction term of Ki67 with multimodality treatment (p = 0.031) translating to an OS of 48.1 months in the low expression Ki67 group compared to 24.3 months in the high Ki67 expression group when receiving surgery within multimodality therapy. Therefore, Ki67 stands out as a validated prognostic and, most importantly, novel predictive biomarker for treatment benefits, particularly regarding surgery within multimodality therapy.

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Letter re: Ki-67 index after neoadjuvant endocrine therapy as a prognostic biomarker in patients with ER-positive/HER2-negative early breast cancer: A systematic review and meta-analysis

Han,

Zhang,

Zhang

et al. 2024

European Journal of Cancer

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Ki-67 index after neoadjuvant endocrine therapy as a prognostic biomarker in patients with ER-positive/HER2-negative early breast cancer: a systematic review and meta-analysis

Cited by 4 publications

References 38 publications

Case report: Primary CDK4/6 inhibitor and endocrine therapy in locally advanced breast cancer and its effect on gut and intratumoral microbiota

Case report: Primary CDK4/6 inhibitor and endocrine therapy in locally advanced breast cancer and its effect on gut and intratumoral microbiota

Ki67 Tumor Expression Predicts Treatment Benefit Achieved by Macroscopic Radical Lung-Preserving Surgery in Pleural Mesothelioma—A Retrospective Multicenter Analysis

Letter re: Ki-67 index after neoadjuvant endocrine therapy as a prognostic biomarker in patients with ER-positive/HER2-negative early breast cancer: A systematic review and meta-analysis

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