SPINK1 and neoplasm: It is possible that trypsin inhibition by SPINK1 results in resistance to anoikis, however this would be counterintuitive, because the established roles for tumor-associated trypsins that have been documented to date are largely of a pro-tumorigenic nature [46], and tumor-associated trypsin secretion has been linked with more malignant ovarian cancers and poorer patient outcomes [16, 47].