ER–/PR+ breast cancer is controlled more effectively with an inflammatory inhibitor than hormonal inhibitor

Christine Song, Ayse Tuba Kendi, Ji Yeon Shim, Dawa Jung, Pil Soo Kang, Val J. Lowe, Seung Baek Lee

Research output: Contribution to journalArticlepeer-review


Background: The anti-estrogen tamoxifen is a highly effective hormonal therapy for hormonal-positive (HR+) breast cancer patients; however, the estrogen receptor-negative, progesterone receptor-positive (ER–/PR+) subtype does not give the benefits of tamoxifen. Therefore ER–/PR+ breast cancer has a poor clinical outcome, and novel drug therapy for ER–/PR+ breast cancer could benefit these patients. Methods: 53,805 gene expressions were characterized into HR+ BC and triple-negative breast cancer (TNBC) and analyzed through Breast Cancer Gene Expression Miner in 4319 breast cancer patient samples. The clinical outcomes including overall survival, distant metastasis-free survival, and relapse-free survival were obtained from the PrognoScan database containing 1190 human breast cancer patient samples. To determine the function of ERα and inflammation-related genes such as USP1, CDC20, and CASP1, we used the CRISPR–Cas9 system or gene knockdown (KD) system. To check tumor cell proliferation and migration of ERα KO breast cancer cell line, we used tamoxifen and the inflammation inhibitor Ac-YVAD-CHO. For further confirmation, cancer growth was checked with the inflammation inhibitor in ERα KO breast cancer cell line using a three-dimensional (3D) organoid tissue culture system (ex vivo). Results: We found that gene expression in ER−/PR+ hormonal-positive breast cancer is positively related to ER–/PR– very similar to TNBC, not other HR+ breast cancer using a 4319 breast cancer patient database. Especially, inflammation-related genes, USP1, CDC20, and CASP1, which are highly expressed in TNBC, are also upregulated in ER−/PR+ HR+ breast cancer. Suppression of USP1, CDC20, and CASP1 inhibited tumor cell growth and metastasis in ERα KO (ER–/PR +) cell lines. Interestingly, loss of ERα in HR+ cell lines is not responsive to tamoxifen, but highly sensitive to the inflammation inhibitor, Ac-YVAD-CHO. In in vitro and ex vivo (3D organoid) models, inflammation inhibitor-specific blocks ER–/PR+ tumor proliferation and migration. Conclusions: These findings suggest that an inflammation inhibitor might be a potential option for therapy for ER–/PR+ HR breast cancer patients.

Original languageEnglish (US)
Pages (from-to)436-452
Number of pages17
JournalBreast Cancer
Issue number3
StatePublished - May 2023


  • CDC20
  • Caspase-1
  • ER–/PR+ hormonal breast cancer
  • Inflammation inhibitor
  • Tamoxifen
  • USP1

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)


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