BCR and metastatic neoplasm: The correlation of low PDE4D7 expression to time to BCR after primary treatment was further re-enforced in the second data set (Boormans et al, 2013), where time to CR demonstrated a fivefold increased risk of reaching the endpoint of metastatic disease within a median of 18 months after surgery when applying a cut-off <0.26 for PDE4D7 expression compared with a median time to CR of 95 months if PDE4D7 expression was >0.26 (HR=0.2; P=2.0E−03) (Figure 6C).