Ki67 Expression Shows Promise as a Predictive Marker for Follicular Lymphoma

According to findings from a study recently published in Leukemia & Lymphoma, high follicular Ki67 expression was associated with longer progression-free survival (PFS) among patients with follicular lymphoma (FL) who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) immunochemotherapy, suggesting its potential as a predictive marker in this treatment regimen. 

Ki67 is a proliferation marker that reflects the growth fraction of tumor cells. Previous studies have indicated that higher Ki67 levels are predictive of enhanced response to chemotherapy-based treatments. 

Meredith M. Nichols, MD, a Robert Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, and coauthors stated that “While the Follicular Lymphoma International Prognostic Index is widely used, reliable prognostic and predictive biomarkers are needed,” as the impetus for their study. 

To expand data on predictive biomarkers for research on follicular lymphoma, Dr Nichols et al aimed to investigate the prognostic and predictive significance of architectural patterns of CD10, BCL6, Ki67, and FOXP1 among patients with follicular lymphoma who had been treated with immunotherapies. The immunotherapies the study authors assessed included bendamustine-rituximab (BR) and rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). 

90 patients with follicular lymphoma who had received either BR or R-CHOP immunotherapy were enrolled in this trial. Architectural patterns of CD10, BCL6, Ki67, and FOXP1 were examined. The primary endpoint was progression-free survival, and secondary endpoints included the determined prognostic and predictive utility of these biomarkers. 

As endpoints were met, Dr Nichols and coauthors concluded, “high follicular Ki67 (≥30%) was associated with longer PFS in the subgroup of patients treated with R-CHOP but not among those treated with BR. Validation of this biomarker may support routine use of Ki67 as a predictive marker in FL.” 

Source: 

Nichols MM, Ondrejka SL, Patil S, Durkin L, Hill BT, Hsi ED. Ki67 proliferation index in follicular lymphoma is associated with favorable outcome in patients treated with R-CHOP. Leukemia & Lymphoma. Published online May 24, 2023:1-9. doi:10.1080/10428194.2023.2214651