Response of Triple Negative Breast Cancer to Neoadjuvant Chemotherapy: Correlation between Ki-67 Expression and Pathological Response

Abstract

Triple-negative breast cancers constitute about 15% of all cases, but despite their higher response to neoadjuvant chemotherapy, the tumors are very aggressive and associated with a poor prognosis as well as a higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III invasive breast cancer who received 6-8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the triple negative breast cancer subgroup. Nuclear Ki-67 expression in both the large cohort group (n=101) and triple negative breast cancer subgroup (n=23) and its relation to the pathological response were evaluated. The purpose of the study was to identify the predictive value of nuclear protein Ki-67 expression among patients with invasive breast cancers, involving the triple negative breast cancer subgroup, treated with neoadjuvant chemotherapy in correlation to the rate of pathological complete response. The proliferation marker Ki-67 expression was highest in the triple negative breast cancer subgroup. No appreciable difference in the rate of Ki-67 expression in triple negative breast cancer subgroup using either a cutoff of 14% or 35%. Triple negative breast cancer subgroup showed lower rates of pathological complete response. Achievement of pathological complete response was significantly correlated with smaller tumor size and higher Ki-67 expression. The majority of triple negative breast cancer cases achieved pathological partial response. The study concluded that Ki-67 is a useful tool to predict chemosensitivity in the setting of neoadjuvant chemotherapy for invasive breast cancer but not for the triple negative breast cancer subgroup.

Neoadjuvant Chemotherapy in Triple Negative Breast Cancer: Correlation between Androgen Receptor Expression and Pathological Response

“…Also, in our results, higher Ki-67 expression, higher grade, and lymph node involvement were statistically significantly correlated with the rate of pCR in the QNBC group (p=0.02, p=0.04, and p=0.03, respectively). This finding matched with the results of many studies evaluated the NAC in TNBC without AR evaluation (Burstein et al, 2008, Keam et al, 2011, and Elnemr et al, 2016. In contrast, no significant association was observed between pCR and clinical-pathological features in the TNBC AR+ group.…”

“…Generally, high Ki-67 expression was significantly associated with the TNBC subtype (Ilie et al, 2018 andElnemr et al, 2016). In the current study, TNBC AR+ has lower proliferation rates and lower histological grade compared with QNBC.…”

A gene signature predicts response to neoadjuvant chemotherapy in triple-negative breast cancer patients

“…Many efforts have been made to identify effective biomarkers. Ki-67 expression was reported associated with response to neoadjuvant chemotherapy [22]. García-Vazquez R found 4 miRNAs (miR-30a, miR-9-3p, miR-770, and miR-143-5p) were associated with pCR to neoadjuvant chemotherapy in TNBC patients [23], while they did not test the predictive efficacy of the 4 miRNAs as a gene signature.…”

Neural network for the prediction of treatment response in Triple Negative Breast Cancer *

“…RCB is a pathological variable based on measurements of how much the primary tumour has shrunk and of the size of metastasis in axillary lymph nodes. Finding biological evidence to NACT response would allow for adequate and specific treatment, some histological variables have been found to be correlated with survival, such as the number Ki-67 positive cells [36], tumor infiltrating lymphocytes [37] and the Elston and Ellis grade [38]. Depending on the context, some alternative treatments have been found to help overall survival, such as those based on anthracycline and taxanes [2], carboplatin [39] or with olaparib and talazoparib [40].…”