Thoughts on tamoxifen resistant breast cancer. Are coregulators the answer or just a red herring?

J Steroid Biochem Mol Biol. 2000 Nov 30;74(5):255-9. doi: 10.1016/s0960-0760(00)00101-1.


The antiestrogen tamoxifen is an effective treatment for estrogen receptor positive breast cancers, slowing tumor growth and preventing disease recurrence, with relatively few side effects. However, many patients who initially respond to treatment, later become resistant to treatment. Tamoxifen has both agonist and antagonist activities, which are manifested in a tissue-specific pattern. Development of tamoxifen resistance can be characterized by an increase in the partial agonist properties of the antiestrogen in the breast, resulting in loss of growth inhibition and even inappropriate tumor stimulation. Nuclear receptor function is modulated by transcriptional coregulators, which either enhance or repress receptor activity. Using a mixed antagonist-biased two-hybrid screening strategy, we identified two such proteins: the human homolog of the nuclear receptor corepressor, N-CoR, and a novel coactivator, L7/SPA (Switch Protein for Antagonists). In transcriptional studies N-CoR suppressed the agonist properties of tamoxifen and RU486, while L7/SPA increased agonist effects. We speculated that the relative level of these coactivators and corepressors might determine the balance of agonist and antagonist properties of mixed antagonists such as tamoxifen. Using quantitative RT-PCR we therefore measured the levels of transcripts encoding these coregulators, as well as the corepressor SMRT, and the coactivator SRC-1, in a small cohort of tamoxifen resistant and sensitive breast tumors. The results suggest that tumor sensitivity to mixed antagonists may be governed by a complex set of transcription factors, which we are only now beginning to understand.

Publication types

  • Review

MeSH terms

  • Animals
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / metabolism*
  • Cell Division / drug effects
  • DNA-Binding Proteins / metabolism
  • Drug Resistance, Neoplasm*
  • Estrogen Receptor Modulators / pharmacology*
  • Estrogen Receptor Modulators / therapeutic use
  • Female
  • Histone Acetyltransferases
  • Humans
  • Mifepristone / pharmacology
  • Nuclear Receptor Co-Repressor 2
  • Nuclear Receptor Coactivator 1
  • Receptors, Estrogen / agonists
  • Receptors, Estrogen / antagonists & inhibitors
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / antagonists & inhibitors
  • Receptors, Progesterone / metabolism
  • Repressor Proteins / metabolism
  • Tamoxifen / pharmacology*
  • Tamoxifen / therapeutic use
  • Transcription Factors / metabolism*


  • DNA-Binding Proteins
  • Estrogen Receptor Modulators
  • NCOR2 protein, human
  • Nuclear Receptor Co-Repressor 2
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Repressor Proteins
  • Transcription Factors
  • Tamoxifen
  • Mifepristone
  • Histone Acetyltransferases
  • NCOA1 protein, human
  • Nuclear Receptor Coactivator 1