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Urokinase-Type Plasminogen Activator and PAI-1

Validated Prognostic Factors for Breast Cancer
  • Michael J. Duffy
Part of the Cancer Drug Discovery and Development book series (CDD&D)

Abstract

Urokinase plasminogen activator (uPA) is a serine protease causally involved in tumor progression. In vivo, uPA can be inhibited by the serpin inhibitor plasminogen activator inhibitor-1 (PAI-1). However, PAI-1 is a multifunctional protein that can also play a role in cell migration, cell adhesion, angiogenesis, and apoptosis. Multiple single-institutional studies have shown that both uPA and PAI-1 are potent and independent prognostic factors in breast cancer. Recently, this prognostic impact was validated in both a prospective randomized trial and a pooled analysis. As well as being prognostic, high levels of uPA/PAI-1 have been shown to predict for relative resistance to hormone therapy in patients with advanced breast cancer but are associated with an enhanced response to adjuvant chemotherapy in early breast cancer. As uPA and PAI-1 are both prognostic and predictive, assay of these factors has the potential to result in the enhanced management of patients with breast cancer. Measurement of these analytes should thus be now considered for use in the routine management of patients with breast cancer.

Key Words

Urokinase plasminogen activator PAI-1 cancer tumor marker Level 1 evidence 

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Copyright information

© Humana Press Inc., Totowa, NJ 2006

Authors and Affiliations

  • Michael J. Duffy
    • 1
  1. 1.Department of Nuclear MedicineSt. Vincent’s HospitalDublinIreland

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