Matrix Metalloproteinase-9 (Mmp-9) And Vascular Endothelial Growth Factor (Vegf) Mrna Expression In Patients With Metastatic Gastric Cancer Receiving First-Line Chemotherapy

4547 Background: In preclinical tumor models, VEGF and MMP-9 induced each other, resulting in the enhancement of tumor angiogenesis and the formation of metastases. This study evaluated MMP-9 and VEGF in patients (pts) with metastatic gastric cancer. Methods: Patient tumor samples from a phase III trial of the AIO were prospectively collected. VEGF and MMP-9 mRNA were isolated from paraffin embedded tissues using a new patented method based on nanotechnology. The expression was then assessed by qRT-PCR and by immunohistochemistry (IHC). Results: A total of 137 (training cohort 96; validation cohort 41) out of 220 pts enrolled were analyzed. In the training cohort, increased MMP-9 levels were strongly associated with increased VEGF expression, resistance to chemotherapy and shorter progression-free and overall survival. At the cut-off with the highest predictive value, the rate of disease progression as best response associated with elevated MMP9 expression was 50% (vs. 22.4%; Fisher's test p=.027) and med...