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Medical Oncology

, Volume 29, Issue 5, pp 3222–3231 | Cite as

Pre-treatment hormonal receptor status and Ki67 index predict pathologic complete response to neoadjuvant trastuzumab/taxanes but not disease-free survival in HER2-positive breast cancer patients

  • Guo-Chun Zhang
  • Xue-Ke Qian
  • Zi-Bai Guo
  • Chong-Yang Ren
  • Meng Yao
  • Xue-Rui Li
  • Kun Wang
  • Jian Zu
  • Ning LiaoEmail author
Original Paper

Abstract

Trastuzumab-containing neoadjuvant chemotherapy achieves a pathologic complete response (pCR) rate of about 40 % in HER2-positive breast cancers, and pCR predicts better survival. A cohort of 102 consecutive Chinese HER2-positive stage II/III patients with neoadjuvant trastuzumab/taxanes were retrospectively analyzed, to evaluate the role of hormonal receptor (HR) status and Ki67 index, along with other parameters, in pCR and survival prediction. pCR rate of the cohort was 44.1 % (45/102). Fifty-three patients were HR-positive and 49 were HR-negative. Median Ki67 index was 40 %, and 49 patients had a high Ki67 index (>40 %) whereas 53 had a low Ki67 index (≤40 %). HR status and Ki67 index were confirmed as the only two parameters associated with pCR in multivariate analysis (hazard ratio = 2.952; 95 % CI, 1.227–7.105; P = 0.016 for HR status and hazard ratio = 2.583, 95 % CI 1.107–6.026, P = 0.028 for Ki67 index). Patients with coexisting HR-negative and high Ki67 index had higher pCR rate (69.2 %), compared to those with either HR-negative alone or high Ki67 alone (hazard ratio = 3.038; 95 % CI, 1.102–8.372; P = 0.029), and to those with coexisting HR-positive and low Ki67 index as well (hazard ratio = 7.071; 95 % CI, 2.150–23.253; P = 0.001). In a median follow-up duration of 25.9 months, 11 disease-free survival events (DFS) were recorded. pCR predicted better DFS (log rank P = 0.018) and was the only significant factor in Cox regression analysis (hazard ratio = 0.184; 95 % CI, 0.038–0.893; P = 0.036). Our study indicates that HR status and Ki67 index are predictors for pCR but not for DFS in HER2-positive patients with neoadjuvant trastuzumab/taxanes, which deserves further investigations.

Keywords

HER2-positive Breast cancer Trastuzumab Neoadjuvant chemotherapy Pathologic complete response Disease-free survival 

Abbreviations

HER2

Human epidermal growth factor receptor 2

HR

Hormonal receptor

ER

Estrogen receptor

PgR

Progesterone receptor

DFS

Disease-free survival

OS

Overall survival

pCR

Pathologic complete response

PR

Partial response

SD

Stable disease

PD

Progressed disease

DCIS

Ductal carcinoma in situ

Notes

Acknowledgments

This work has been supported by two grants encoded as 81001189 and 81071851 from the National Natural Science Foundation of China. We thanked Dr. Xu Fang-Ping for performing the Ki67 re-examination in our study as well as for kindly providing us the delicate pathologic photos.

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Guo-Chun Zhang
    • 1
  • Xue-Ke Qian
    • 1
    • 2
  • Zi-Bai Guo
    • 1
    • 2
  • Chong-Yang Ren
    • 1
    • 3
  • Meng Yao
    • 1
  • Xue-Rui Li
    • 1
  • Kun Wang
    • 1
  • Jian Zu
    • 1
  • Ning Liao
    • 1
    Email author
  1. 1.Department of Breast Cancer, Cancer Center, Guangdong General HospitalGuangdong Academy of Medical SciencesGuangzhouChina
  2. 2.Shantou University Medical SchoolShantouChina
  3. 3.Southern Medical UniversityGuangzhouChina

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