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Tamoxifen Action in ER-Negative Breast Cancer
Subrata Manna1, Marina K Holz2
1Department of Biology, Yeshiva University, New York, NY, USA.
Abstract:
Breast cancer is a highly heterogeneous disease. Tamoxifen is a selective estrogen receptor (ER) modulator and is mainly indicated for the treatment of breast cancer in postmenopausal women and postsurgery neoadjuvant therapy in ER-positive breast cancers. Interestingly, 5-10% of the ER-negative breast cancers have also shown sensitivity to tamoxifen treatment. The involvement of molecular markers and/or signaling pathways independent of ER signaling has been implicated in tamoxifen sensitivity in the ER-negative subgroup. Studies reveal that variation in the expression of estrogen-related receptor alpha, ER subtype beta, tumor microenvironment, and epigenetics affects tamoxifen sensitivity. This review discusses the background of the research on the action of tamoxifen that may inspire future studies to explore effective therapeutic strategies for the treatment of ER-negative and triple-negative breast cancers, the latter being an aggressive disease with worse clinical outcome.
Insights
Tamoxifen shows effectiveness in some estrogen receptor-negative breast cancers, independent of ER signaling. Further research into molecular markers could improve treatments for ER-negative and triple-negative breast cancers.
Area of Science:
- Oncology
- Pharmacology
Background:
- Breast cancer heterogeneity impacts treatment efficacy.
- Tamoxifen, a selective estrogen receptor (ER) modulator, is standard for ER-positive breast cancer.
- A subset of ER-negative breast cancers also respond to tamoxifen.
Purpose of the Study:
- To review tamoxifen's action in ER-negative breast cancer.
- To explore molecular mechanisms beyond ER signaling in tamoxifen sensitivity.
- To guide future therapeutic strategies for ER-negative and triple-negative breast cancers.
Main Methods:
- Literature review of studies on tamoxifen sensitivity in breast cancer.
- Analysis of molecular markers and signaling pathways.
- Examination of epigenetic factors and tumor microenvironment.
Main Results:
- Tamoxifen sensitivity in ER-negative breast cancer is linked to ER-independent pathways.
- Estrogen-related receptor alpha, ER subtype beta, tumor microenvironment, and epigenetics influence response.
- ER-negative and triple-negative breast cancers present unique therapeutic challenges.
Conclusions:
- Understanding ER-independent pathways is crucial for treating ER-negative breast cancers.
- Targeting these pathways may offer new therapeutic avenues.
- Further research is needed to develop effective strategies for aggressive breast cancer subtypes.
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