1. PREOPERATIVE PLASMA CONCENTRATION OF MMP-9/TIMP-1 COMPLEXES IS NOT ASSOCIATED WITH DISEASE OUTCOME IN PRIMARY BREAST CANCER (N=483) Anne-Sofie Schrohl 1, Sidse Ørnbjerg Würtz 1, Susanne Møller 2, Birgitte Sander Nielsen 1, Henning T. Mouridsen 2, and Nils Brünner 1 1 University of Copenhagen, Faculty of Life Sciences & Sino-Danish Breast Cancer Research Centre, Copenhagen, Denmark 2 Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark Contact: sofie@life.ku.dk RESULTS ASSAY AND SAMPLES AIM & HYPOTHESIS Plasma MMP-9/TIMP- 1 complex levels were not associated with age, lymph node status, steroid hormone receptor status, or tumor size. Significant associations with tumor grade (p=0.04) and menopausal status (p=0.001) were found. Table 1. Patient and tumor characteristics and association with MMP-9/TIMP-1 complexes Characteristic All patients (N=483) MMP-9/TIMP-1 P (Χ 2 -test) Q1-25 (%) Q25-50 (%) Q50-75 (%) Q75-100 (%) Age ≤ 50 years 50-69 years ≥ 70 years 107 271 105 36 25 23 15 26 25 27 23 31 22 27 21 0.06 Lymph node status Positive Negative 228 255 25 28 22 24 26 25 27 23 0.70 Hormone rec. status Positive Negative Unknown 395 83 5 26 31 25 17 25 24 28 0.21 Tumor size 0-20 mm > 20 mm 316 167 27 26 24 22 25 26 24 26 0.92 Tumor grade Grade 1 Grade 2 and 3 Unknown 206 244 33 26 28 29 18 23 29 22 26 0.04 Menopausal status Premenopausal Postmenopausal 145 338 35 23 15 27 26 25 23 25 0.001 CONCLUSIONS ACKNOWLEDGEMENTS VariableHazard ratio95% CIP MMP-9/TIMP-1 complex Q25-50 vs. Q1-25 Q50-75 vs. Q1-25 Q75-100 vs. Q1-25 0.95 1.01 0.92 0.55-1.62 0.61-1.68 0.55-1.57 0.84 0.96 0.77 Age 50-69 years vs. < 50 years ≥ 70 years vs. < 50 years 0.99 2.48 0.45-2.21 1.61-3.83 0.99 < 0.0001 Lymph node status Positive vs. negative 1.180.80-1.750.40 Hormone rec. status Positive vs. negative 0.460.29-0.730.001 Tumor size > 20 mm vs. 0-20 mm 1.310.88-1.950.18 Tumor grade Grade 2 and 3 vs. grade 1 1.340.86-2.080.20 Menopausal status Post- vs. premenopausal 1.340.64-2.840.44 Only age ≥ 70 years and steroid hormone receptor status contributed significantly to the multivariable model. MMP-9/TIMP-1 complex levels were not associated with recurrence-free survival. Table 2. Multivariable Cox proportional hazards model of recurrence-free survival Figure 1. Recurrence-free survival of patients grouped in quartiles by plasma MMP- 9/TIMP-1 level Plasma levels of MMP-9/TIMP-1 complexes were not associated with recurrence-free survival (logrank test p=0.9565). Proportion alive without recurrence  No association was found between plasma concentration of MMP-9/TIMP-1 complexes and disease outcome  These results suggest that other fractions of MMP-9 and TIMP-1 carry prognostic information, e.g. free MMP-9 and TIMP-1 or MMP-9 and TIMP-1 bound to other plasma proteins This work was supported by The Danish Cancer Society Anne-Sofie Schrohl is supported by the Danish Council for Independent Research | Medical Sciences Both Matrix Metalloproteinase-9 (MMP-9) and Tissue Inhibitor of Metalloproteinases-1 (TIMP-1) are associated with a poor prognosis in breast cancer. Here, our aim was to measure the concentration of MMP-9/TIMP-1 complexes in plasma from primary breast cancer patients and to evaluate whether these levels are associated with disease outcome. The hypothesis was that high plasma levels of MMP-9/TIMP-1 complexes are associated with increased recurrence risk in primary breast cancer patients. MMP-9/TIMP-1 COMPLEX ELISA The human MMP-9/TIMP-1 Complex DuoSet® ELISA Development System (R&D Systems, Inc.) was validated for measurement of MMP-9/TIMP-1 complex levels in human plasma. The validation process included investigation of reproducibility (intra-assay, inter-assay), recovery, and linearity upon dilution of samples. PLASMA SAMPLES Preoperative EDTA plasma samples from 483 consecutively enrolled primary breast cancer patients were analyzed. Prior to analysis, samples were diluted in reagent diluent as recommended by the manufacturer (1:3). The median MMP-9/TIMP-1 complex concentration was 2.06 ng/mL (range, 0.11 - >14.8 ng/mL). DATA ANALYSIS The possible associations between MMP-9/TIMP-1 plasma level and patient- and tumor characteristics were analyzed using a Χ 2 test. The possible association with recurrence-free survival was investigated using a logrank test and a multivariable Cox proportional hazards model. In the analyses, patients were grouped in quartiles based on their plasma MMP-9/TIMP-1 complex level. Recurrence-free survival was defined as survival without breast cancer relapse, contralateral breast cancer, other malignant disease and death without a previous relapse. 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