Serological Markers TIMP-1, PAI-1, MASP-2, and C-reactive protein are independent predictors of colorectal cancer-related death, according to a presentation at the annual meeting of the American Association of Cancer Research.

In the Danish study, blood taken from 654 colorectal cancer patients just before they had surgery was retrospectively analyzed for expression of the proteins. The test identified the 308 patients who later died of the disease, some up to nine years after surgery.

“The results show that the outcome of a significant number of patients was correctly identified, independent of stage and location,” said the lead author, Hans J. Nielsen, M, DMSc., Professor of Surgical Oncology at Hvidovre University Hospital.

When tumor stage and location were factored into the test, the concordance between predicted survival and actual survival was 79 percent, Nielsen said.

“This protein profile might be used to identify groups of patients who, independent of stage, should be offered adjuvant chemotherapy, and groups of patients who should not be offered chemotherapy,” Nielsen said. “Such possible patient differentiation should, of course, be confirmed in prospective studies.”

Such a study is currently underway in Denmark and other Scandinavian countries, he said. Up to 1,500 patients will be enrolled and blood samples will be collected periodically, such as before and after every treatment. The four protein markers will then be validated for disease stage, primary and secondary treatment, recurrence, and survival, and may prove to be predictive of response to individual therapies, as well as survival, Nielsen said.

The protein markers included in the test --- TIMP-1, PAI-1, MASP-2, and CRP --- are related to tissue remodeling, angiogenesis, and inflammation. The test uses antibodies that specifically bind to the proteins, and can analyze the actual concentration of these proteins.