%0 Journal Article
%T Ki67, chemotherapy response, and prognosis in breast cancer patients receiving neoadjuvant treatment
%A Peter A Fasching
%A Katharina Heusinger
%A Lothar Haeberle
%A Melitta Niklos
%A Alexander Hein
%A Christian M Bayer
%A Claudia Rauh
%A Ruediger Schulz-Wendtland
%A Mayada R Bani
%A Michael Schrauder
%A Laura Kahmann
%A Michael P Lux
%A Johanna D Strehl
%A Arndt Hartmann
%A Arno Dimmler
%A Matthias W Beckmann
%A David L Wachter
%J BMC Cancer
%D 2011
%I BioMed Central
%R 10.1186/1471-2407-11-486
%X Ki67 was stained routinely from core biopsies in 552 patients directly after the fixation and embedding process. HER2/neu, estrogen and progesterone receptors, and grading were also assessed before treatment. These data were used to construct univariate and multivariate models for predicting pCR and prognosis. The tumors were also classified by molecular phenotype to identify subgroups in which predicting pCR and prognosis with Ki67 might be feasible.Using a cut-off value of > 13% positively stained cancer cells, Ki67 was found to be an independent predictor for pCR (OR 3.5; 95% CI, 1.4, 10.1) and for overall survival (HR 8.1; 95% CI, 3.3 to 20.4) and distant disease-free survival (HR 3.2; 95% CI, 1.8 to 5.9). The mean Ki67 value was 50.6 ¡À 23.4% in patients with pCR. Patients without a pCR had an average of 26.7 ¡À 22.9% positively stained cancer cells.Ki67 has predictive and prognostic value and is a feasible marker for clinical practice. It independently improved the prediction of treatment response and prognosis in a group of breast cancer patients receiving neoadjuvant treatment. As mean Ki67 values in patients with a pCR were very high, cut-off values in a high range above which the prognosis may be better than in patients with lower Ki67 values may be hypothesized. Larger studies will be needed in order to investigate these findings further.The aim in modern, individualized medicine is to identify patients who have an unfavorable prognosis -- or even better, to identify patients who may be capable of benefiting from an improved prognosis associated with a specific form of treatment. There has recently been discussion on whether the proliferation marker Ki67 might be suitable for inclusion in everyday clinical practice, although it was considered that the marker is not yet ready for routine use [1]. In novel multigene tests, however, proliferation has a major impact on calculations of the risk of recurrence. Ki67 itself is already part of a multigene test [2] t
%U http://www.biomedcentral.com/1471-2407/11/486