Prognostic and Predictive Value of Centrally Reviewed Ki-67 Labeling Index in Postmenopausal Women With Endocrine-Responsive Breast Cancer: Results From Breast International Group Trial 1-98 Comparing Adjuvant Tamoxifen With Letrozole

Viale, G. et al. (2008) Prognostic and Predictive Value of Centrally Reviewed Ki-67 Labeling Index in Postmenopausal Women With Endocrine-Responsive Breast Cancer: Results From Breast International Group Trial 1-98 Comparing Adjuvant Tamoxifen With Letrozole. Journal of Clinical Oncology, 26(34), pp. 5569-5575. (doi: 10.1200/JCO.2008.17.0829)

Abstract

Purpose To evaluate the prognostic and predictive value of Ki-67 labeling index (LI) in a trial comparing letrozole (Let) with tamoxifen (Tam) as adjuvant therapy in postmenopausal women with early breast cancer. Patients and Methods Breast International Group ( BIG) trial 1-98 randomly assigned 8,010 patients to four treatment arms comparing Let and Tam with sequences of each agent. Of 4,922 patients randomly assigned to receive 5 years of monotherapy with either agent, 2,685 had primary tumor material available for central pathology assessment of Ki-67 LI by immunohistochemistry and had tumors confirmed to express estrogen receptors after central review. The prognostic and predictive value of centrally measured Ki- 67 LI on disease-free survival (DFS) were assessed among these patients using proportional hazards modeling, with Ki- 67 LI values dichotomized at the median value of 11%. Results Higher values of Ki- 67 LI were associated with adverse prognostic factors and with worse DFS (hazard ratio [HR; high: low] = 1.8; 95% CI, 1.4 to 2.3). The magnitude of the treatment benefit for Let versus Tam was greater among patients with high tumor Ki- 67 LI (HR [Let: Tam] = 0.53; 95% CI, 0.39 to 0.72) than among patients with low tumor Ki- 67 LI (HR [Let: Tam] = 0.81; 95% CI, 0.57 to 1.15; interaction P = .09). Conclusion Ki- 67 LI is confirmed as a prognostic factor in this study. High Ki- 67 LI levels may identify a patient group that particularly benefits from initial Let adjuvant therapy.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Gusterson, Professor Barry
• Authors: Viale, G., Giobbie-Hurder, A., Regan, M. M., Coates, A. S., Mastropasqua, M. G., Dell'Orto, P., Maiorano, E., MacGrogan, G., Braye, S. G., Ohlschlegel, C., Neven, P., Orosz, Z., Olszewski, W. P., Knox, F., Thurlimann, B., Price, K. N., Castiglione-Gertsch, M., Gelber, R. D., Gusterson, B. A., and Goldhirsch, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences
• Journal Name: Journal of Clinical Oncology
• ISSN: 0732-183X