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Analysis of Ki‐67 expression with neoadjuvant anastrozole or tamoxifen in patients receiving goserelin for premenopausal breast cancer
Author(s) -
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
Publication year - 2012
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.27818
Subject(s) - anastrozole , medicine , goserelin , tamoxifen , breast cancer , oncology , proliferation index , urology , estrogen receptor , antiestrogen , gynecology , cancer , immunohistochemistry
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.