Childs, A;
Kirkwood, A;
Edeline, J;
Tu, VL;
Watkins, J;
Lamarca, A;
Alrifai, D;
... Meyer, T; + view all
(2016)
Ki-67 index and response to chemotherapy in patients with neuroendocrine tumours.
Endocrine-Related Cancer
, 23
(7)
pp. 563-570.
10.1530/ERC-16-0099.
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Abstract
Chemotherapy (CT) is widely used for neuroendocrine tumours (NETs), but there are no validated biomarkers to predict response. The Ki-67 proliferation index has been proposed as a means of selecting patients for CT, but robust data are lacking. The aim of this study was to investigate the relationship between response to chemotherapy and Ki-67 in NET. We reviewed data from 222 NET patients treated with CT. Tumours were graded according to Ki-67 index: G1 ≤2%, G2 3–20% and G3 >20%. Response was assessed according to RECIST and survival calculated from start of chemotherapy to death. To explore Ki-67 as a marker of response, we calculated the likelihood ratio and performed receiver operating characteristic analysis. Overall, 193 patients had a documented Ki-67 index, of which 173 were also evaluable for radiological response: 10% were G1, 46% G2 and 43% G3; 46% were pancreatic NET (PNET). Median overall survival was 22.1 months. Overall response rate was 30% (39% in PNET vs 22% in non-PNET) and 43% of patients had stable disease. Response rate increased with grade: 6% in G1 tumours, 24% in G2 and 43% in G3. However, maximum likelihood ratio was 2.3 at Ki-67=35%, and the area under the ROC curve was 0.60. As reported previously, a high Ki-67 was an adverse prognostic factor for overall survival. In conclusion, response to CT increases with Ki-67 index, but Ki-67 alone is an unreliable means to select patients for CT. Improved methods to stratify patients for systemic therapy are required.
| Type: | Article |
|---|---|
| Title: | Ki-67 index and response to chemotherapy in patients with neuroendocrine tumours |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1530/ERC-16-0099 |
| Publisher version: | https://doi.org/10.1530/ERC-16-0099 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Oncology, Endocrinology & Metabolism, neuroendocrine tumour, chemotherapy, Ki-67, response, RADIOLABELED SOMATOSTATIN ANALOG, PANCREATIC ENDOCRINE CARCINOMAS, STREPTOZOCIN PLUS FLUOROURACIL, ISLET-CELL CARCINOMA, PROGNOSTIC-FACTORS, GRADING SYSTEM, DOXORUBICIN, THERAPY, SURVIVAL, TEMOZOLOMIDE |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > CRUK Cancer Trials Centre UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10049170 |
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