Abstract

Simple SummaryBreast cancer represents the most frequently diagnosed carcinoma and the leading cause of cancer death in women. Despite advances achieved in systemic therapy, about one-third of all patients relapse and develop a metastatic disease, which ultimately leads to breast cancer deaths. In this scenario, the identification of new prognostic factors and pharmacological tools is needed to improve breast cancer management. Peroxisome proliferator-activated receptor gamma (PPARγ), belonging to the nuclear receptor superfamily, is a ligand-dependent transcription factor expressed in many tumors including breast cancer, and its function upon binding of ligands has been linked to the tumor development, progression and metastasis. Over the last decade, much research has focused on the implication of natural and synthetic PPARγ agonists in the negative regulation of breast cancer growth and progression. The aim of the present review is to summarize the role of PPARγ activation in breast cancer from the basic research to clinical studies. The therapeutic effects of natural and synthetic PPARγ ligands, as antineoplastic agents, represent a fascinating and clinically a potential translatable area of research with regards to the battle against cancer.Peroxisome proliferator-activated receptor gamma (PPARγ), belonging to the nuclear receptor superfamily, is a ligand-dependent transcription factor involved in a variety of pathophysiological conditions such as inflammation, metabolic disorders, cardiovascular disease, and cancers. In this latter context, PPARγ is expressed in many tumors including breast cancer, and its function upon binding of ligands has been linked to the tumor development, progression, and metastasis. Over the last decade, much research has focused on the potential of natural agonists for PPARγ including fatty acids and prostanoids that act as weak ligands compared to the strong and synthetic PPARγ agonists such as thiazolidinedione drugs. Both natural and synthetic compounds have been implicated in the negative regulation of breast cancer growth and progression. The aim of the present review is to summarize the role of PPARγ activation in breast cancer focusing on the underlying cellular and molecular mechanisms involved in the regulation of cell proliferation, cell cycle, and cell death, in the modulation of motility and invasion as well as in the cross-talk with other different signaling pathways. Besides, we also provide an overview of the in vivo breast cancer models and clinical studies. The therapeutic effects of natural and synthetic PPARγ ligands, as antineoplastic agents, represent a fascinating and clinically a potential translatable area of research with regards to the battle against cancer.

Highlights

  • Breast cancer represents the most frequently diagnosed carcinoma and the leading cause of cancer death in women [1]

  • estrogen receptor α (ERα) physically interacts with peroxisome proliferator-activated receptor γ (PPARγ) in a multiprotein complex involving p85, the regulatory subunit of the phosphatidylinositol 3-kinase (PI3K) survival pathway, even though ligand-activated PPARγ, exerting an opposite effect on the PI3K/AKT transduction pathway compared to ERα, induces breast cancer cell growth inhibition

  • Despite the large number of preclinical studies investigating the role of ligand-activated PPARγ in breast cancer, only a few clinical trials have been conducted, and the results mainly address the potential of PPARγ agonists on breast cancer risk in healthy women and on the modulation of chemotherapy-related side effects in breast cancer patients

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Summary

Introduction

Breast cancer represents the most frequently diagnosed carcinoma and the leading cause of cancer death in women [1]. Patients with TNBC, which accounts for 10–20% of all cases of breast carcinoma, have a relatively poor outcome and require additional treatment approaches since this tumor subtype is characterized by the lack of biomarker expression [8]. In this scenario, the identification of new prognostic factors and pharmacological tools is needed to improve breast cancer management. Activation of PPARγ by its natural and synthetic agonists has been found to modulate the expression of several genes associated with tumorigenesis, further highlighting that this nuclear receptor could represent a new promising target for the treatment of breast cancer. This review could allow a better comprehension of the PPARγ agonists as potential pharmacological or nutritional compounds against breast cancer

Search Strategy and Data Extraction
Genomic Organization and Tissue Distribution of PPARγ
PPARγ Domain Structure
The Mechanism of Action of PPARγ
Natural PPARγ Ligands
Synthetic PPARγ Ligands
The Role of the PPARγ Ligands in Breast Cancer
In Vitro Studies
Regulation of Cell Growth and Cell Cycle
Regulation of Cell Death
Regulation of Motility and Invasion
Cross-Talk of PPARγ with Other Signal Transduction Pathways
In Vivo Studies
Clinical Studies
Findings
Conclusions
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