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Elevated plasma tissue inhibitor of metalloproteinase-1 levels predict decreased survival in castration-resistant prostate cancer patients

✍ Scribed by William K. Oh; Roberto Vargas; Susanna Jacobus; Kim Leitzel; Meredith M. Regan; Peter Hamer; Karen Pierce; Sheryl Brown-Shimer; Walter Carney; Suhail M. Ali; Philip W. Kantoff; Allan Lipton


Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
220 KB
Volume
117
Category
Article
ISSN
0008-543X

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✦ Synopsis


Abstract

BACKGROUND.

Tissue inhibitor of metalloproteinase‐1 (TIMP‐1) has paradoxical multifunctional roles in tumorigenesis: inhibition of the catalytic activity of matrix metalloproteinases and apoptosis as well as promotion of angiogenesis and tumor growth. Elevated TIMP‐1 levels have been associated with a poorer prognosis in multiple cancers.

METHODS.

Ethylenediaminetetraacetic acid plasma TIMP‐1 was determined in 362 castration‐resistant prostate cancer (PC) patients using a TIMP‐1 enzyme‐linked immunosorbent assay. All patients with castration‐resistant PC and available plasma were identified from an institutional database. Overall survival was analyzed using the Kaplan‐Meier method and Cox modeling on plasma TIMP‐1 tertiles.

RESULTS.

Patients were evaluated in pilot (n = 60) and primary (n = 302) sets. Median follow‐up from diagnosis was 5.8 and 6.6 years, respectively. Median plasma TIMP‐1 levels were 335 and 183 ng/mL in the pilot and primary sets, respectively. Overall survival was significantly shorter with each higher tertile of TIMP‐1 in both datasets (P<.001). For the primary cohort, hazard ratio of (HR) death and median survival by plasma TIMP‐1 tertile levels were: low, HR 1.0, 43 months; middle, HR 1.7, 27 months; high, HR 2.4, 19 months. In the primary set, significant covariates in the adjusted Cox regression model were: TIMP‐1 level (mid or high vs low tertile), prostate‐specific antigen (>20 vs ≤20 ng/mL), alkaline phosphatase (>102 vs ≤102 U/L), Eastern Cooperative Oncology Group performance status (1 + vs 0), and Gleason score (7 or 8 vs ≤6).

CONCLUSIONS.

Elevated plasma TIMP‐1 levels predicted decreased survival in metastatic castration‐resistant PC patients, independent of known prognostic markers. Cancer 2011. © 2010 American Cancer Society.


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