Neoadjuvant Chemotherapy and Pathologic Complete Response in HR+/HER2- Breast Cancer: Impact of Tumor Ki67 and ER Status.
Chemotherapy
; 69(3): 141-149, 2024.
Article
en En
| MEDLINE
| ID: mdl-38368871
ABSTRACT
INTRODUCTION:
Neoadjuvant chemotherapy (NAC) is extensively employed in breast cancer (BC), primarily for aggressive subtypes like triple-negative and human epidermal growth factor receptor 2 (HER2)-positive BC and in estrogen receptor-positive (ER+)/HER2- BC with high-risk features. In ER+/HER2- BC, pathological complete rates are much lower (<10%), while axillary dissection rates are higher. This study focuses on hormone receptor-positive (HR+)/HER2- BC patients undergoing NAC, examining its impact on pathological complete response (pCR) rates, with specific attention to tumor Ki67 and ER status.METHODS:
Retrospective data analysis from Kartal Dr. Lütfi Kirdar City Hospital included HR+/HER2- BC patients who received NAC. Clinicopathological factors, NAC response, and surgical outcomes were assessed. Statistical analyses evaluated the association between Ki67, ER status, and pCR.RESULTS:
Of 203 patients, 11.8% achieved pCR. Ki67 (p < 0.001) and ER percentage (p < 0.001) significantly correlated with pCR. Higher Ki67 was associated with increased pCR likelihood (HR 1.03, 95% CI 1.01-1.05). A Ki67-pCR probability curve revealed a cutoff of 23.5%. ER%-pCR analysis showed decreasing pCR rates with higher ER percentages. Multivariate analysis confirmed Ki67 (p = 0.003, HR 1.02) and ER percentage (p = 0.019, HR 0.97) as independent predictors of pCR probability.CONCLUSION:
Consideration of Ki67 and ER percentage aids in NAC decisions for HR+/HER2- BC, identifying patients with high NAC response rates, facilitating axillary preservation, and potentially avoiding axillary dissection. The pCR rates in patients with Ki67 ≤24 are particularly low, especially in patients with a high ER percentage. In these cases, upfront surgery and adjuvant treatment should be considered instead of NAC.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
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Receptores de Estrógenos
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Receptor ErbB-2
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Antígeno Ki-67
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Terapia Neoadyuvante
Límite:
Adult
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Aged
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Chemotherapy
Año:
2024
Tipo del documento:
Article
País de afiliación:
Turquía