Proteases and metastasis: clinical relevance nowadays?

Area of Science:

• Oncology
• Biochemistry
• Molecular Biology

Background:

• Breast cancer research focuses on prognostic and predictive markers for recurrence risk and therapy response.
• Proteases, including matrix metalloproteinases, urokinase plasminogen activator, and cathepsins, are implicated in cancer progression and metastasis.
• This review covers recent advancements in protease-based markers for breast cancer.

Purpose of the Study:

• To review recent developments in prognostic and predictive markers for breast cancer.
• To evaluate the clinical utility of proteases and their inhibitors in breast cancer management.

Main Methods:

• Review of recent scientific literature and meta-analyses.
• Analysis of prospective randomized clinical studies providing level 1 evidence.
• Assessment of findings on matrix metalloproteinases, urokinase plasminogen activator, cathepsins, and their inhibitors.

Main Results:

• Urokinase plasminogen activator and plasminogen activator inhibitor 1 demonstrated confirmed prognostic value via meta-analysis and level 1 evidence studies.
• Encouraging data suggest urokinase plasminogen activator and plasminogen activator inhibitor 1 may also serve as predictive markers.
• Findings on matrix metalloproteinases, cathepsins, and their inhibitors remain inconclusive regarding prognostic and predictive value.

Conclusions:

• Tumor urokinase plasminogen activator and plasminogen activator inhibitor 1 levels are suitable for clinical use in selecting patients for adjuvant systemic therapy.
• Standardization of matrix metalloproteinases and cathepsins assays is needed to define their clinical relevance in breast cancer.