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Published on: June 9, 2023
FOXO factors and breast cancer: outfoxing endocrine resistance
1Hormones and Cancer GroupCancer Genetics Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, Pacific Highway Saint Leonards, Sydney, New South Wales 2065, Australia martyn.bullock@sydney.edu.au.
Abstract:
The majority of metastatic breast cancers cannot be cured and present a major public health problem worldwide. Approximately 70% of breast cancers express the estrogen receptor, and endocrine-based therapies have significantly improved patient outcomes. However, the development of endocrine resistance is extremely common. Understanding the molecular pathways that regulate the hormone sensitivity of breast cancer cells is important to improving the efficacy of endocrine therapy. It is becoming clearer that the PI3K-AKT-forkhead box O (FOXO) signaling axis is a key player in the hormone-independent growth of many breast cancers. Constitutive PI3K-AKT pathway activation, a driver of breast cancer growth, causes down-regulation of FOXO tumor suppressor functions. This review will summarize what is currently known about the role of FOXOs in endocrine-resistance mechanisms. It will also suggest potential therapeutic strategies for the restoration of normal FOXO transcriptional activity.
Insights
Estrogen receptor-positive breast cancers often develop endocrine resistance. This review explores how the PI3K-AKT-forkhead box O (FOXO) pathway contributes to resistance and suggests therapies to restore FOXO function.
Area of Science:
- Oncology
- Molecular Biology
- Endocrinology
Background:
- Metastatic breast cancer is a significant global health issue, with most cases incurable.
- Estrogen receptor-positive breast cancers (approximately 70%) benefit from endocrine therapy, but resistance is common.
- Understanding hormone sensitivity is crucial for improving endocrine therapy efficacy.
Purpose of the Study:
- To review the role of the PI3K-AKT-forkhead box O (FOXO) signaling axis in endocrine resistance mechanisms of breast cancer.
- To explore how PI3K-AKT pathway activation impacts FOXO tumor suppressor functions.
- To propose potential therapeutic strategies for restoring normal FOXO transcriptional activity.
Main Methods:
- Literature review of current research on FOXO signaling in breast cancer.
- Analysis of molecular pathways involved in endocrine resistance.
- Synthesis of information on therapeutic interventions targeting FOXO.
Main Results:
- The PI3K-AKT-FOXO signaling axis is implicated in hormone-independent breast cancer growth.
- Constitutive activation of the PI3K-AKT pathway leads to decreased FOXO tumor suppressor activity.
- FOXO dysfunction is a key factor in the development of endocrine resistance.
Conclusions:
- Restoring normal FOXO transcriptional activity may overcome endocrine resistance.
- Targeting the PI3K-AKT-FOXO pathway offers potential therapeutic avenues for metastatic breast cancer.
- Further research into FOXO-mediated mechanisms is essential for advancing breast cancer treatment.
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