# Promotion of ER+ Breast Cancer Progression in the Elderly

> **NIH NIH F30** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2022 · $47,941

## Abstract

PROJECT SUMMARY / ABSTRACT
Breast cancer is the second leading cause of cancer-related deaths in women. Over two-thirds of all breast
cancer cases are considered estrogen receptor positive (ER+). Significantly, ER+ breast cancer incidence
correlates strongly with aging, rising to a peak incidence in women aged 70 years or older (elderly). Owing in
large part to the differences in physiologic estrogen signaling and the chronic inflammatory state that develops
as people age, ER+ breast cancer that develops in the elderly population exhibits distinct clinical and
biologically behavior from ER+ breast cancer in younger cohorts. Clinically, while endocrine therapy continues
to be a mainstay of treatment, there is a major push for de-implementation of invasive and adverse effect-
causing interventions in the elderly that do not impact disease-specific survival. Our group has recently shown
that in elderly patients with early stage ER+, clinically node-negative tumors, de-implementation of both
sentinel lymph node biopsy and radiation therapy can be safely omitted without compromising local
recurrence-free or disease-free survival. Biologically, intrinsic epigenomic and transcriptomic as well as
changes to local breast microenvironment all contribute to a unique landscape for tumor pathogenesis in aged
individuals. The interplay and disease-causing roles of these factors requires further investigation.
 We will investigate several key questions in this translational proposal: (1) What factors that arise in the
backdrop of age-induced chronic inflammation may contribute to distinct tumor signaling in aged ER+ breast
tumors? Using patient tumor and plasma samples, we will characterize cytokines, chemokines, and estrogen
profiles, connecting these extrinsic factors with transcriptomic alterations in the tumor cell using RNA
sequencing. (2) Can we mechanistically understand the crosstalk between altered inflammatory axis signaling
and estrogen receptor signaling in ER+ breast cancer models? We hypothesize that the inflammatory
cytokines and chemokines present in the breast microenvironment alter ER signaling through the estrogen-
sensitive NF-kB / IL-6 / STAT3 inflammatory axis, and this may be a novel therapeutic target for treating elderly
breast cancer. (3) Does pharmacological modulation of this pathway using low-cost, well-tolerated, readily
available drugs result in stunted ER+ breast cancer growth?
 This proposal will ultimately lead to a better understanding of the unique molecular drivers of ER+
breast cancer in the elderly. Successful completion of these Aims will provide the foundation for future studies
and clinical trials to better define treatment standards for elderly patients, who are traditionally both
understudied and underrepresented in clinical trials. Further, this proposal will provide me with an exemplary
translational platform and research training, working with a collaborative group of clinicians and scientists to
launch my career a...

## Key facts

- **NIH application ID:** 10455463
- **Project number:** 5F30CA264963-02
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Neil Carleton
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $47,941
- **Award type:** 5
- **Project period:** 2021-08-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10455463

## Citation

> US National Institutes of Health, RePORTER application 10455463, Promotion of ER+ Breast Cancer Progression in the Elderly (5F30CA264963-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10455463. Licensed CC0.

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