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The prognostic value of changes in Ki67 following neoadjuvant chemotherapy in residual triple-negative breast cancer: a Swedish nationwide registry-based study

  • 0Department of Surgery, Region Västra Götaland, Skaraborg Hospital, Skövde, Sweden. jenny.nyqvist@gu.se.
Breast Cancer Research and Treatment +

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January 12, 2025

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January 12, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Changes in Ki67 levels after neoadjuvant chemotherapy (NACT) in triple-negative breast cancer (TNBC) are linked to survival. Unchanged Ki67 post-NACT indicates poorer outcomes, emphasizing the need for tailored treatments and monitoring.

Area Of Science

  • Oncology
  • Breast Cancer Research
  • Chemotherapy Efficacy

Background

  • Triple-negative breast cancer (TNBC) is an aggressive subtype requiring effective treatment strategies.
  • Neoadjuvant chemotherapy (NACT) is a standard treatment for TNBC, aiming to reduce tumor burden before surgery.
  • Ki67 is a proliferation marker often used to assess tumor aggressiveness and response to therapy.

Purpose Of The Study

  • To investigate the prognostic value of Ki67 changes (pre- and post-NACT) in primary invasive TNBC.
  • To determine if Ki67 dynamics predict disease-specific survival (DSS) and overall survival (OS) in TNBC patients.

Main Methods

  • Retrospective analysis of a population-based TNBC registry (2007-2021, n=9262).
  • Multivariable Cox regression analysis for DSS and OS, adjusting for age and residual disease in breast and nodes (RDBN).
  • Evaluation of Ki67 levels before and after NACT in 1777 TNBC patients.

Main Results

  • NACT generally reduced tumor size and Ki67 levels, but 75% of patients had unchanged or increased Ki67 post-treatment.
  • Patients with unchanged Ki67 post-NACT showed significantly worse OS (66%) and DSS (78%) at 5 years compared to those with decreased Ki67 (OS: 87%; DSS: 89%).
  • Pathologic complete response (pCR) was associated with 5-year survival, but only RDBN score independently predicted survival in multivariable analysis.

Conclusions

  • Persistent or increased Ki67 levels after NACT in TNBC are associated with adverse clinical outcomes.
  • These findings underscore the importance of individualized treatment approaches for TNBC.
  • Dynamic monitoring of Ki67 levels post-NACT is crucial for identifying patients who may benefit from alternative or intensified treatment strategies.

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