Predictive Roles of Ki 67 level & mPEPI Score for Neoadjuvant ‘Chemotherapy’ Efficacy in Locally Advanced ER(+)/HER2(-) Breast Cancer
UHOD - Uluslararasi Hematoloji-Onkoloji Dergisi, cilt.34, sa.3, ss.123-130, 2024 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 34 Sayı: 3
- Basım Tarihi: 2024
- Doi Numarası: 10.4999/uhod.247632
- Dergi Adı: UHOD - Uluslararasi Hematoloji-Onkoloji Dergisi
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.123-130
- Anahtar Kelimeler: ER+/HER2-breast cancer, Locally advanced breast cancer, Luminal-like breast cancer, mPEPI score, Neoadjuvant treatment
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Neoadjuvant chemotherapy (NAC) & modified preoperative endocrine prognostic index (mPEPI) score after NAC role is unclear in locally advanced ER+/HER2(-) breast cancer (LA-HnLBC). We aimed to evaluate prognostic & predictive factors including mPEPI score for NAC in LA-HnLBC, retrospectively. 142 LA-HnLBC patients were classified as pCR(n:26) & non-pCR (n: 116) & categorized for PR/ki67/ki67 decline/mPEPI score patients were included. Median age was 53 years. pCR rate was 18.3%. Median ER/PR/ki67 were as 90% / 40% / 40%. Median basal & postoperative ki67 level was 40. pCR group had more T2(73%), grade 3 (69%) & non-pCR had more T3(21%), grade 2(46%) tumors (p= 0.03,p= 0.03). pCR group had lower mPEPI score (3.5 vs 5,p= 0.05). 5y-DFS was 69% (pCR 93.8%,non-pCR 63.4%, p= 0.012). 5y-OS was 77% (pCR 100%,non-pCR 72%, p= 0.018). In univariate analysis, high basal/ postoperative ki67 levels, ki67 decline & mPEPI score were significant poor prognostic factors for DFS (p= 0.01, p< 0.001, p= 0.017, p< 0.001) & OS (p= 0.006, p= 0.003, p= 0.05, p= 0.001) in non-pCR goup. Prognostic cut-offs were as 40 for basal ki67 (DFS & OS), 20 for postoperative ki67 (DFS), 4 for mPEPI (DFS) & 30 for ki67 decline (OS). Favorable prognostic factors were defined as lower basal ki67 level (< 40%) & higher ki67 decline (ki67 <30%) for OS; lower basal ki67 (<40%), po ki 67 (< 20%) & mPEPI score (< 4) for DFS after NAC in LA HnLBC. Different prognostic cut-offs for basal & postoperative ki 67 is striking. mPEPI score may also have prognostic significance after NAC in LA-HnLBC patients.