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ESMO 2025 | MonarchE: Ki-67 dynamics and prognostic value in HR+/HER2- breast cancer

Shigehira Saji, MD, PhD, Fukushima Medical University, Fukushima, Japan, discusses the MonarchE trial (NCT03155997) evaluating the prognostic and predictive value of Ki-67 in patients with hormone receptor (HR)-positive, HER2-negative, node-positive high-risk breast cancer receiving neoadjuvant chemotherapy. Analyses show that high Ki-67 pre- or post-chemotherapy and persistence of high Ki-67 post-treatment are associated with increased recurrence risk. Importantly, the benefit of adjuvant abemaciclib plus endocrine therapy was consistent across all Ki-67 subgroups, supporting its broad efficacy regardless of Ki-67 dynamics. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.

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Transcript

Dr. Martin presented about the MonarchE study. In the MonarchE study, there are patients who have received neoadjuvant chemotherapy. They evaluated the Ki67 index before neoadjuvant chemotherapy and after neoadjuvant chemotherapy. They found that the change between pre and post-treatment in terms of Ki67 has a very good prognostic factor which can predict the patient prognosis, especially the Ki67 high to high patient, low to low patient...

Dr. Martin presented about the MonarchE study. In the MonarchE study, there are patients who have received neoadjuvant chemotherapy. They evaluated the Ki67 index before neoadjuvant chemotherapy and after neoadjuvant chemotherapy. They found that the change between pre and post-treatment in terms of Ki67 has a very good prognostic factor which can predict the patient prognosis, especially the Ki67 high to high patient, low to low patient. So these are very separate, very much in terms of the prognosis and there is a high to low patient in that case I’ve made a note, 0.35, so it seems it might be by chance but it might be much more than other patterns, but anyway, as a result, Ki67 between the neurological and chemistry before and after can predict the patient’s prognosis more precisely, and the adjuvant therapy works in any kind of situation, so this is not an efficacy predictive archetype.

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