Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Clinical significance of Ki-67 index expression in advanced non-small cell lung cancer.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
J Clin Oncol 37, 2019 (suppl; abstr e20576)
Author(s): Di ming Wang, Qingming Shi; Thoracic Clinical College of Anhui Medical University (Anhui chest hospital) Jixi, Hefei City, China; Anhui Chest Hospital, Heifei, China
Background: It is unclear how the Ki-67 index expression affects the objective response to chemotherapy in non-small cell lung cancer(NSCLC). The study analyzed the relationship among the Ki-67 index, the objective response rate and progression-free survival(PFS) of chemotherapy in ad-NSCLC. Methods: 112 patients of advanced NSCLC in our hospital from 2014 to 2017 were studied. Both EGFR and ALK were wild type in adenocarcinoma patients, and no gene test was performed in squamous carcinoma. The relationship among Ki-67 index ,tumor stage, response of chemotherapy and progression-free survival was analyzed by univariate and multivariate analysis.Ki-67 index was used to predict the objective response of chemotherapy by receiver operating characteristic curve(ROC curve). Results: The objective response rate of chemotherapy was 61.6%(69/112);squamous carcinoma was 69.1%(38/55);adenocarcinoma was 54.4%(31/57). Ki-67 index(P = 0.000) and tumor stage(P = 0.025) were the factors influencing the objective efficacy of chemotherapy.Ki-67 index was linearly correlated with tumor stage (r = 0.341,P = 0.001).In the univariate and multivariate analyses, the Ki-67 index was significantly associated with the objective response to chemotherapy (B = -0.069,P = 0.000).Ki-67 index expression can accurately predict the objective response rate of ad-NSCLC chemotherapy by ROC curve(P < 0.0001,AUC = 0.7467,95%CI = 0.6578-0.8356):squamous carcinoma group (P = 0.0003,AUC = 0.8065,95%CI = 0.6922- 0.9208), adenocarcinoma group (P = 0.0193, AUC = 0.681,95%CI = 0.536-0.8262).In the test cohort, the sensitivity of the Ki-67 index to the objective response rate of chemotherapy was 93.02%.In the squamous carcinoma group the sensitivity was 94.12%.In the adenocarcinoma group the sensitivity was 65.54%.The best Cut-off was 55% for the adenocarcinoma group with good chemotherapeutic efficacy and the adenocarcinoma group with poor efficacy. The best Cut-off value was 65% in squamous carcinoma group with good curative effect and squamous carcinoma group with poor curative effect.The overexpression of Ki-67 index was a negative prognostic factor for PFS in ad-NSCLC (P < 0.0001):squamous carcinoma (P = 0.0055), adenocarcinoma (P < 0.0001). In multivariate Cox analysis, Ki-67 index (P = 0.000) and stage (P = 0.001) were negative factors of PFS. Conclusions: Ki-67 index is a clinically significant biomarker in ad-NSCLC, which can predict the objective efficacy of chemotherapy. The high expression of Ki-67 might be an indicator of the shortened PFS time.