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Updated: May 27, 2026

Systems Biology of Metabolic Regulation by Estrogen Receptor Signaling in Breast Cancer
Published on: March 17, 2016
ERα-dependent E2F transcription can mediate resistance to estrogen deprivation in human breast cancer
Todd W Miller1, Justin M Balko, Emily M Fox
1Department of Cancer Biology, Breast Cancer Research Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee 37232-6307, USA.
Abstract:
Most estrogen receptor α (ER)-positive breast cancers initially respond to antiestrogens, but many eventually become estrogen-independent and recur. We identified an estrogen-independent role for ER and the CDK4/Rb/E2F transcriptional axis in the hormone-independent growth of breast cancer cells. ER downregulation with fulvestrant or small interfering RNA (siRNA) inhibited estrogen-independent growth. Chromatin immunoprecipitation identified ER genomic binding activity in estrogen-deprived cells and primary breast tumors treated with aromatase inhibitors. Gene expression profiling revealed an estrogen-independent, ER/E2F-directed transcriptional program. An E2F activation gene signature correlated with a lesser response to aromatase inhibitors in patients' tumors. siRNA screening showed that CDK4, an activator of E2F, is required for estrogen-independent cell growth. Long-term estrogen-deprived cells hyperactivate phosphatidylinositol 3-kinase (PI3K) independently of ER/E2F. Fulvestrant combined with the pan-PI3K inhibitor BKM120 induced regression of ER(+) xenografts. These data support further development of ER downregulators and CDK4 inhibitors, and their combination with PI3K inhibitors for treatment of antiestrogen-resistant breast cancers.
Insights
Estrogen receptor alpha (ER) plays a role in hormone-independent breast cancer growth. Targeting ER, CDK4, and PI3K may overcome antiestrogen resistance.
Area of Science:
- Oncology
- Molecular Biology
- Endocrinology
Background:
- Estrogen receptor-positive (ER+) breast cancers often develop resistance to antiestrogen therapies.
- Understanding the mechanisms of hormone-independent growth is crucial for improving treatment outcomes.
Purpose of the Study:
- To investigate the role of ER and the CDK4/Rb/E2F axis in estrogen-independent breast cancer growth.
- To identify potential therapeutic targets for overcoming antiestrogen resistance.
Main Methods:
- Utilized ER downregulation with fulvestrant and siRNA.
- Performed chromatin immunoprecipitation and gene expression profiling.
- Conducted siRNA screening for CDK4 and tested combination therapies in xenografts.
Main Results:
- ER downregulation inhibited estrogen-independent growth.
- Identified an ER/E2F-directed transcriptional program active in hormone-deprived cells.
- CDK4 is essential for estrogen-independent growth; PI3K pathway is hyperactivated.
- Combination of fulvestrant and BKM120 induced xenograft regression.
Conclusions:
- ER has an estrogen-independent role in breast cancer growth.
- The CDK4/Rb/E2F axis is implicated in antiestrogen resistance.
- Targeting ER, CDK4, and PI3K concurrently shows promise for treating resistant breast cancers.
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