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- Title
Analysis of Ki-67 expression with neoadjuvant anastrozole or tamoxifen in patients receiving goserelin for premenopausal breast cancer.
- Authors
Iwata, Hiroji; Masuda, Norikazu; Sagara, Yasuaki; Kinoshita, Takayuki; Nakamura, Seigo; Yanagita, Yasuhiro; Nishimura, Reiki; Iwase, Hirotaka; Kamigaki, Shunji; Takei, Hiroyuki; Tsuda, Hitoshi; Hayashi, Nobuya; Noguchi, Shinzaburo
- Abstract
BACKGROUND: The increasing costs associated with large-scale adjuvant trials mean that the prognostic value of biologic markers is increasingly important. The expression of nuclear antigen Ki-67, a marker of cell proliferation, has been correlated with treatment efficacy and is being investigated for its value as a predictive marker of therapeutic response. In the current study, the authors explored correlations between Ki-67 expression and tumor response, estrogen receptor (ER) status, progesterone receptor (PgR) status, and histopathologic response from the STAGE study ( S_tudy of T_amoxifen or A_rimidex, combined with G_oserelin acetate to compare E_fficacy and safety). METHODS: In a phase 3, double-blind, randomized trial (National Clinical Trials identifier NCT00605267), premenopausal women with ER-positive, early stage breast cancer received either anastrozole plus goserelin or tamoxifen plus goserelin for 24 weeks before surgery. The Ki-67 index, hormone receptor (ER and PgR) status, and histopathologic responses were determined from histopathologic samples that were obtained from core-needle biopsies at baseline and at surgery. Tumor response was determined by using magnetic resonance imaging or computed tomography. RESULTS: In total, 197 patients were randomized to receive either anastrozole plus goserelin (n = 98) or tamoxifen plus goserelin (n = 99). The best overall tumor response was better for the anastrozole group compared with the tamoxifen group both among patients who had a baseline Ki-67 index ≥20% and among those who had a baseline Ki-67 index <20%. There was no apparent correlation between baseline ER status and the Ki-67 index in either group. Positive PgR status was reduced from baseline to week 24 in the anastrozole group. CONCLUSIONS: In premenopausal women with ER-positive breast cancer, anastrozole produced a greater best overall tumor response compared with tamoxifen regardless of the baseline Ki-67 index. Cancer 2013. © 2012 American Cancer Society.
- Subjects
BREAST cancer treatment; GENE expression; ANASTROZOLE; TAMOXIFEN; GOSERELIN; PERIMENOPAUSE; ADJUVANT treatment of cancer
- Publication
Cancer (0008543X), 2013, Vol 119, Issue 4, p704
- ISSN
0008-543X
- Publication type
Article
- DOI
10.1002/cncr.27818