Evidence map›Paper›PMID 34671036›Full record

ArticleNPJ breast cancer2021

IHC-based Ki67 as response biomarker to tamoxifen in breast cancer window trials enrolling premenopausal women.

Stacey E P Joosten, Marius Wellenstein, Rutger Koornstra, Annelot van Rossum, Joyce Sanders, Vincent van der Noort, Maria C Ferrandez, Rolf Harkes, Ingrid A M Mandjes, Hilde Rosing and 7 more

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in NPJ breast cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00738777 (A Randomized, Prospective Trial of 2-6 Weeks Pre-operative Hormonal Treatment for Hormone Receptor Positive Breast Cancer), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00738777 phase2suspendednot on this map

A Randomized, Prospective Trial of 2-6 Weeks Pre-operative Hormonal Treatment for Hormone Receptor Positive Breast Cancer: Anastrozole +/- Fulvestrant or Tamoxifen Exposure - Response in Molecular Profile (AFTER-study).

TypeinterventionalSponsorThe Netherlands Cancer InstituteRan2008 to 2024Enrolled250ConditionsBreast CancerArmsAnastrozole, Anastrozole+Fulvestrant, Tamoxifen
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 6 institutions in 1 country.

Stacey E P JoostenDivision of Oncogenomics, Oncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Marius WellensteinWSK Medical B.V, Amsterdam, The Netherlands.
Rutger KoornstraDepartment of Internal Medicine and Medical Oncology, Rijnstate hospital, Arnhem, The Netherlands.
Annelot van RossumDivision of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Joyce SandersDepartment of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-0551-7813
Vincent van der NoortDepartment of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Maria C FerrandezDepartment of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Rolf HarkesDepartment of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Ingrid A M MandjesDepartment of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Hilde RosingDepartment of Pharmacy and Pharmacology, Antoni van Leeuwenhoek-The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Alwin HuitemaDepartment of Pharmacy and Pharmacology, Antoni van Leeuwenhoek-The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jos H BeijnenDepartment of Pharmacy and Pharmacology, Antoni van Leeuwenhoek-The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jelle WesselingDepartment of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-8940-2676
Paul J van DiestDepartment of Pathology, University Medical Centre, Utrecht, The Netherlands.
Hugo M HorlingsDivision of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. h.horlings@nki.nl.ORCID http://orcid.org/0000-0003-4782-8828
Sabine C LinnDivision of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. s.linn@nki.nl.
Wilbert ZwartDivision of Oncogenomics, Oncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands. w.zwart@nki.nl.
The Netherlands Cancer Institute · NLUniversity Medical Center Utrecht · NLUtrecht University · NLLeiden University Medical Center · NLOncode Institute · NLRijnstate Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Window studies are gaining traction to assess (molecular) changes in short timeframes. Decreased tumor cell positivity for the proliferation marker Ki67 is often used as a proxy for treatment response. Immunohistochemistry (IHC)-based Ki67 on tissue from neo-adjuvant trials was previously reported to be predictive for long-term response to endocrine therapy for breast cancer in postmenopausal women, but none of these trials enrolled premenopausal women. Nonetheless, the marker is being used on this subpopulation. We compared pathologist assessed IHC-based Ki67 in samples from pre- and postmenopausal women in a neo-adjuvant, endocrine therapy focused trial (NCT00738777), randomized between tamoxifen, anastrozole, or fulvestrant. These results were compared with (1) IHC-based Ki67 scoring by AI, (2) mitotic figures, (3) mRNA-based Ki67, (4) five independent gene expression signatures capturing proliferation, and (5) blood levels for tamoxifen and its metabolites as well as estradiol. Upon tamoxifen, IHC-based Ki67 levels were decreased in both pre- and postmenopausal breast cancer patients, which was confirmed using mRNA-based cell proliferation markers. The magnitude of decrease of Ki67 IHC was smaller in pre- versus postmenopausal women. We found a direct relationship between post-treatment estradiol levels and the magnitude of the Ki67 decrease in tumors. These data suggest IHC-based Ki67 may be an appropriate biomarker for tamoxifen response in premenopausal breast cancer patients, but anti-proliferative effect size depends on estradiol levels.

Identifiers

PMID34671036
PMCPMC8528844
OpenAlexW3206770118

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.