The predictive value of Ki-67 before neoadjuvant chemotherapy for breast cancer: a systematic review and meta-analysis

What is it about?

 This systematic review of 53 studies (10848 patients) showed there was a statistical difference in pCR between high and low Ki 67 expression for breast cancer patients who received neoadjuvant chemotherapy.  The variations in Ki 67cutoff points and pCR definitions did not change the statistical difference in pCR between high and low Ki 67 expression.  Ki 67 could also predict pCR in HR+, HER2+ and triple negative breast cancer patients, those who received NAC containing plus taxanes and anthracyclines only, and those from Asia and Europe, but not in ER- breast cancer patients, those who received taxanes only and those from America.  No consensus achieved on the standard values for classifying Ki-67 as high or low, we found 15% and 20% might be good cut-off points, which were due to highest OR values and consistent results across studies and low statistical heterogeneity.  We could conclude that Ki 67 might predict the response by pCR and detection of pre-treatment Ki67 could identify patients most likely to benefit from NAC.

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