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Biomark Insights. 2016 Aug 16;11:105-11. doi: 10.4137/BMI.S33372. eCollection 2016.

Plasminogen Activator System and Breast Cancer: Potential Role in Therapy Decision Making and Precision Medicine.

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Laboratory of Biochemistry, Faculty of Medicine, Badji Mokhtar University, Annaba, Algeria.
Department of Internal Medicine, EL OKBI Public Hospital, Guelma, Algeria.
Independent Research Team in Cancer Biology and Bioactive Compounds, Faculty of Medicine and Pharmacy, Mohamed 1st University, Oujda, Morocco.
Laboratory of Biochemistry, La Timone University Hospital of Marseille, France.
Clinical Pharmacokinetics Laboratory, SMARTc unit, Inserm S911 CRO2, La Timone University Hospital of Marseille, France.
Oncopharmacology Unit, Centre Antoine Lacassagne, Nice, France.


Shifting from the historical TNM paradigm to the determination of molecular and genetic subtypes of tumors has been a major improvement to better picture cancerous diseases. The sharper the picture is, the better will be the possibility to develop subsequent strategies, thus achieving higher efficacy and prolonged survival eventually. Recent studies suggest that urokinase-type plasminogen activator (uPA), uPA Receptor (uPAR), and plasmino-gen activator inhibitor-1 (PAI-1) may play a critical role in cancer invasion and metastasis. Consistent with their role in cancer dissemination, high levels of uPA, PAI-1, and uPAR in multiple cancer types correlate with dismal prognosis. In this respect, upfront determination of uPA and PAI-1 as invasion markers has further opened up the possibilities for individualized therapy of breast cancer. Indeed, uPA and PAI-1 could help to classify patients on their risk for metastatic spreading and subsequent relapse, thus helping clinicians in their decision-making process to propose, or not propose, adjuvant therapy. This review covers the implications for cancer diagnosis, prognosis, and therapy of uPA and PAI-1, and therefore how they could be major actors in the development of a precision medicine in breast cancer.


breast cancer; precision medicine; therapy decision; urokinase plasminogen activator

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