For example, despite its function as an inhibitor of urokinase and tissue-type plasminogen activator (PA), PA inhibitor-1 (PAI-1) has a paradoxical pro-tumorigenic role in cancer, promoting angiogenesis and tumor cell survival and, as a biomarker in breast cancer, is validated for prognostic use in level-of-evidence-1 studies [35]. This evidence concerns the gene SERPINE1 and neoplasm.