Ki-67 With MRI in Predicting the Complete Pathological Response Post-neoadjuvant Chemotherapy

Area of Science:

• Oncology
• Radiology
• Biomarker Analysis

Background:

• Neoadjuvant chemotherapy (NAC) is crucial for high-risk breast cancer, with pathologic complete response (pCR) indicating favorable outcomes.
• Accurate prediction of pCR is essential for tailoring NAC and improving patient survival.
• Current assessment methods can be enhanced by integrating imaging and biomarker data.

Purpose of the Study:

• To evaluate the predictive validity of combined MRI and Ki-67 metrics for assessing pCR in breast cancer patients undergoing NAC.
• To compare the performance of integrated MRI-Ki-67 models against single-modality approaches.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA guidelines.
• Inclusion of ten studies assessing NAC-treated breast cancer patients using MRI and Ki-67.
• Evaluation of predictive models using AUC and calibration metrics, focusing on MRI tumor size reduction and Ki-67 levels.

Main Results:

• High Ki-67 levels and significant MRI tumor size reduction are consistent predictors of pCR (AUCs near 0.90).
• Integrated MRI-Ki-67 models demonstrated superior predictive accuracy and calibration compared to individual markers.
• Significant heterogeneity (I² = 77%) was observed, indicating variability in assessment protocols.

Conclusions:

• Combined MRI and Ki-67 offer robust, non-invasive prediction of pCR, providing structural and biological insights.
• Integrated models represent a significant advancement toward personalized breast cancer treatment.
• Standardization of imaging and biomarker protocols is recommended for improved model reproducibility and clinical integration.