KI-67 Tumor levels....

[Jean]

http://www.medicalnewstoday.com/medicalnews.php?newsid=61006&nfid=al

Jean

[Hopeful]

Jean, I saw this, too, but didn't post it because I was confused by the following:

"The researchers found that higher Ki67 expression after 2 weeks of presurgical therapy was associated with worse recurrence-free survival. There was no association between the Ki67 level before therapy and recurrence-free survival. They also found that larger tumor size before therapy and lower estrogen receptor level after 2 weeks of treatment were associated with worse recurrence-free survival."

FYI, the "therapy" referred to above is endocrine therapy in hormone positive patitents. I am confused about the "larger tumor size before therapy and lower estrogen receptor level after 2 weeks of therapy." Does this mean that estrogen is being downregulated by the hormone therapy, and the cancer is finding another path to grow? I guess that would indicate a bad result as the tumor is no longer capable of endocrine manipulation?

Thanks,

Hopeful

[Jean]

Hi Hopeful,
The research showed that Ki67 expression after short term endocrine treatment may improve the predicition of recurrence free survival.

As far as the estrogen being downregulated by the hormone therapy I am not
sure that is what the article is representing. Maybe this is why the question
of chemo treatment comes into play, meaning that AI or Tamoxifen treatment is not the best course of action for a tumor that has a high Ki67 level. They say it "may improve" recurrence free survival. This also ties in with the Oncotype DX test where a patient is on the fence with a treatment choice. This article is saying that pre-surgical therapy did not enhance recurrence free survival but rather it was worse. Hence maybe chemo should be applied. Maybe I am reading this wrong but that is what I have gotten out of the article. They need to do additional testing. I do know that when the Ki67 levels are high that is often the ticket to chemo. (at least when I met with Dr. Slamon he discussed with me my Ki67 level and this was a strong factor.)

Regards,
Jean

[Hopeful]

Jean,

Thanks for your interpretation. Sometimes these articles take language out of the paper they are reviewing and print it verbatim. The research papers often contain some cryptic writing that does not make sense out of context. I do understand that the high Ki-67 levels after two weeks of endocrine therapy was associated with higher risk of recurrence. I can also relate that to what Dr. Slamon told you about high Ki-67 and chemo. I am interested in reading about studies done with Ki-67, because they don't come along all that often.

BTW, I went to the link for the abstract of the paper from which this article was drawn: http://jnci.oxfordjournals.org/cgi/content/abstract/99/2/167 I found the "context and caveats" section very helpful. This must have been a whopper to parse through!

Hopeful