Personalized treatment of malignant tumours according to Ki67

Nuclear protein Ki67 suitable as a biomarker for pleural mesothelioma. International study by Karl Landsteiner University of Health Sciences confirms Ki67’s high informative value for tumour aggressiveness and surgical treatment success. Therapy individualization possible.

Krems (Austria), 26. June 2024: The nuclear protein Ki67 is a meaningful biomarker for tumour aggressiveness and for the success of surgical therapy in pleural mesothelioma, a malignant disease of the pleura. This is the clear and promising result of an international study now published by Karl Landsteiner University of Health Sciences (KL Krems) in collaboration with Gazi University, Ankara, Turkey. The study compared the survival rates and overall survival of patients with high and low expression of Ki67 in tumour tissue. It was found that low expression was associated with significantly better prognosis and a better response to surgery for those affected.

Pleural mesothelioma is an aggressive tumour of the pleura, a tissue that surrounds the lungs. It is often triggered by exposure to asbestos, but other causes are also known. Its diagnosis and treatment remain a major challenge, and the prognosis for those affected is still not good. Biomarkers that allow the characterization of individual tumours would help. However, even the few candidates that have been considered so far are not yet sufficiently established for everyday clinical use. Now a study by KL Krems is attracting widespread attention. It shows that the extent of expression of the cell nucleus protein Ki67 makes it possible to draw conclusions about the aggressiveness of the tumour and the prospects of success of certain treatment strategies.

Aggressiveness

„Ki67 is a protein of the cell nucleus that is specifically expressed, i.e. produced, during cell division,“ explains study leader Dr Bahil Ghanim from the Division of General and Thoracic Surgery at Krems University Hospital (a teaching and research site of KL Krems). In simple terms, tissue with many dividing cells contains more Ki67 than tissue with fewer such cells. As tumour tissue with a particularly large number of cell divisions is considered to be extremely aggressive, Ki67 can provide information on biological aggressiveness. „The expression rate of the Ki67 genes is a suitable measurement. This indicates the proportion of cells in a tissue that are currently dividing and therefore producing Ki67,“ explains Dr Ghanim. „And indeed, my team and I were already able to show in a previous study that this value has prognostic value, particularly in epithelioid pleural mesothelioma. Now we have taken a closer look at this.“

Dr Sarah Hintermair, co-first author of the study and colleague of Dr Ghanim explains: „We analysed tumour samples from 70 patients, about half of whom were treated in Krems, the other half in Turkey, Gazi University, an important scientific partner. After measuring the expression rate, the patients were divided into two groups: those with an expression rate above and those with an expression rate below 15%. We then compared 5-year survival and average overall survival – and saw differences with clear statistical significance and high clinical importance.“

Clear Evidence

The results now published in Cancers show that the 5-year survival rate for patients with low Ki67 expression was over 4 times higher than for those with higher expression. These results reveal that the expression rate of Ki67 can be used to predict the further course of the disease.

Dr Ghanim’s team then investigated whether Ki67 could also provide information about the likely success of certain forms of therapy. In fact, pleural mesothelioma is currently being treated in a variety of controversial ways, with multimodal treatments – i.e. treatments that combine several therapeutic approaches including surgery – being quite common. „We therefore correlated our data on the Ki67 expression rate not only with the survival values, but also with the treatment options that the respective patients received,“ says Dr Stephanie Iser, who is the first author of the study together with Dr Hintermaier. Here, too, the study shows a clear result: if the disease was treated multimodally, including surgery, the average overall survival of 4 years in the group with a low Ki67 expression rate was twice as long as in the equally treated group with high Ki67 expression. Dr Iser comments: „Ki67 is therefore also very well suited as a predictive biomarker that can provide information on the suitability of a specific form of treatment, including thoracic surgery. This means that Ki67 makes it possible for the first time to individualize the treatment of epithelioid pleural mesothelioma.“ A result of research at KL Krems with high clinical relevance and significance for the quality of life and treatment response for those affected.

Original publication: Ki67 Tumour Expression Predicts Treatment Benefit Achieved by Macroscopic Radical Lung-Preserving Surgery in Pleural Mesothelioma-A Retrospective Multicenter Analysis. S. Hintermair, S. Iser, A. Varga, M. Biesinger, T. Bohanes, A. Celik, M. Sayan, A. Kankoç, N. Akyurek, B. Öğüt, E. Stubenberger, B. Ghanim. Cancers, Volume 16, Issue 10, May 2024, DOI 10.3390/cancers16101817. Link to the publication: https://kris.kl.ac.at/en/publications/ki67-tumour-expression-predicts-treatment-benefit-achieved-by-macr

Karl Landsteiner University of Health Sciences (06/2024)

The Karl Landsteiner University of Health Sciences (KL Krems) is an educational and research institution on the Campus Krems and recognised throughout Europe. KL Krems offers modern, demand-oriented education and continuing education in medicine and psychology as well as a PhD programme in Mental Health and Neuroscience. The flexible educational programme is tailored to the needs of students, the requirements of the labour market and the challenges of science. The three university hospitals in Krems, St. Pölten and Tulln and the MedAustron Ion Therapy and Research Centre in Wiener Neustadt guarantee clinical teaching and research of the highest quality. In its research, KL Krems focuses on interdisciplinary fields with high relevance to health policy – including biomechanics, molecular oncology, mental health and neuroscience as well as the topic of water quality and the associated health aspects. KL Krems was founded in 2013 and accredited by the Austrian Agency for Quality Assurance and Accreditation (AQ Austria). https://www.kl.ac.at/en

Scientific Contact

Dr. Bahil Darson Ghanim

Division of General and Thoracic Surgery at Krems University Hospital

Karl Landsteiner University of Health Sciences

Dr.-Karl-Dorrek-Straße 30

3500 Krems / Österreich

T +43 2732 72090 470

E Bahil.Ghanim@kl.ac.at

W http://www.kl.ac.at

Karl Landsteiner University of Health Sciences

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