High intra-tumoral and serum matrix metalloproteinase 9 levels are associated with reduced survival of patients with glioblastoma and brain metastases

Purpose: Matrix metalloproteinase 9 (MMP-9) has been shown to promote glioblastoma invasion and the spread of brain metastases (BM). However, the current literature on its link to patient survival is inconsistent. This study examines intra-tumoral and sera MMP-9 levels and their correlation with overall survival (OS) in patients with glioblastoma and BM. Methods: A total of 69 tumor and pre-operative serum samples were collected from the brain tumor bank at the neurosurgery department of Soroka University Medical Center. These samples were obtained from patients who underwent tumor resection between 2015 and 2021. Clinical and imaging data from 27 glioblastoma patients and 30 individuals with brain metastases were analyzed, measuring and comparing their intra-tumoral and sera MMP-9 levels and activity against those of 12 meningioma patients and 23 healthy controls. Survival analyses were performed to examine the relationship between MMP-9 levels, activity, and clinical parameters. Results: Patients with glioblastoma and BM showed higher median intra-tumoral MMP-9 levels (8 ng/ml and 4 ng/ml, respectively, p