Purpose: The role of cyclin E as a predictive marker of response to chemotherapy remains unknown. We have previously shown that deregulation of cyclin E in an ovarian tumor cell line model enhances cyclin E^associated kinase activity and sensitizes tumor cells to cisplatinum. We hypothesized that cyclin E deregulation would predict for responsiveness to platinum-based regimens in ovarian cancer patients. Experimental Design: Patients who met the following criteria were retrospectively identified from the institutional tumor bank records: (a) high-grade ovarian epithelial malignancy, (b) stage III/stage IV disease, (c) optimally debulked, (d) completed platinum-based therapy. Tumor samples were analyzed for cyclin E, p21, and p27 byWestern blot analysis and assessed for cyclin E^associated kinase activity. Results: Seventy-five patients, who met the study criteria, were identified. Cyclin E protein levels did not correlate with cyclin E^cdk2 kinase activity (Spearman's rho, 0.07; P = 0.58). Cyclin E^associated kinase activity was the only significant predictive marker for response to platinum-based therapy, with higher response rates seen in patients with higher levels of activity (P = 0.045). Cyclin E protein levels did not predict for platinum sensitivity (P = 0.20). In contrast, cyclin E protein levels, but not cyclin E^associated kinase activity, was a significant predictor for freedom from recurrence (P = 0.01and P = 0.25, respectively). Conclusions: Cyclin E overexpression and cyclin E^associated kinase activity have distinct roles in predicting for response to chemotherapy and outcome in ovarian cancer patients. These results suggest a compartmentalization of cyclin E functions in the oncogenic process.Overexpression of the cyclin E protein has been linked to shortening of the G 1 phase of the cell cycle (1), decreased requirement for growth factors (1), enhanced cell proliferation (2), induction of chromosomal instability (3, 4), and polyploidy (5). These processes contribute toward the oncogenic potential of cyclin E. Most importantly, cyclin E protein levels have been shown to correlate with a more aggressive tumor phenotype and adverse prognosis in a number of malignancies including breast, ovarian, gastric, non -small cell, and adrenocortical carcinomas, as well as non-Hodgkin's lymphoma (6-15).The major form of deregulation of cyclin E is at the level of protein. In examining cyclin E deregulation in breast cancer, we have previously published that irrespective of whether or not the gene is amplified (which occurs only in 10% of all breast cancer cases), the protein is independently deregulated. In fact, we have shown that in both normal and tumor cells, at the level of RNA, cyclin E is present as multiple splice variants; however, these splice variants do not give rise to protein products (16). Therefore, it seems that the primary process that contributes to deregulation of cyclin E is through posttranslational proteolytic cleavage of the full-length protein by elastase, which results in ge...