Mechanism of Endocrine Therapy Resistance in Breast Cancer

Dear Colleagues, 

Approximately 75-80% of all breast tumors express the estrogen receptor (ER+) and respond to drugs that target the ER or the ER signaling pathway. These includes adjuvant tamoxifen, used primarily in premenopausal patients, and aromatase inhibitors (AIs), including letrozole, anastrozole, and exemestane, used primarily in postmenopausal patients. Unfortunately, as many as 50% of ER+ breast cancer patients will develop metastatic or advanced localized disease, wherein most tumors will remain ER+ but develop adaptive resistance to tamoxifen and/or AIs. The first-line treatment of ER+ metastatic breast cancer (MBC) includes the use of AIs or selective estrogen receptor degraders (SERDs), including fulvestrant, elacestrant, and, more recently, imlunestrant (specifically in ESR1 mutant tumors). SERDs can be used alone but are most often used in combination with a CDK4/6 inhibitor (palbociclib, abemaciclib, or ribociclib). For third-line treatment, chemotherapy is commonly used in patients lacking any actionable mutations and may include antibody-drug conjugates (ADCs) such as sacituzumab govitecan (Trodelvy). For this Special Issue, “Mechanism of Endocrine Therapy Resistance in Breast Cancer”, we welcome original articles and reviews sharing new findings on topics including novel mechanisms behind endocrine resistance, predictive biomarkers, innovative pathological approaches, new drug targets, and novel therapeutics, as well as clinical updates. We believe that the discovery of new therapeutic approaches will allow patients to receive treatment earlier and will result in improved outcomes and the avoidance of cytotoxic chemotherapy. 

Prof. Dr. Debra A. Tonetti
Dr. Clodia Osipo
Guest Editors

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