Estrogen induces death of tamoxifen-resistant MCF-7 cells: contrasting effect of the estrogen receptor downregulator fulvestrant. Journal   The Journal of steroid biochemistry and molecular biology. Citation   J Steroid Biochem Mol Biol. 98(4-5):193-8 Publication date   2006 Mar Authors   Planas-Silva MD Waltz PK Kilker RL Investigators   Maricarmen D. Planas-Silva MeSH headings   Apoptosis Breast Neoplasms Drug Resistance, Neoplasm Estradiol Estrogens Receptors, Estrogen Tamoxifen MeSH qualifiers   drug effects drug therapy analogs & derivatives pharmacology antagonists & inhibitors Abstract   A common problem in breast cancer therapy is resistance to the antiestrogen tamoxifen. However, tamoxifen-resistant breast tumors can still respond to other hormonal therapies. In animal models of tamoxifen-resistant breast cancer cells, physiological levels of estrogen can induce tumor regression. Recently, the estrogen receptor downregulator fulvestrant was shown to promote tumor growth of tamoxifen-resistant cells when added in combination with physiological levels of estrogen. Here, we show, using a cell culture model, that continuous exposure of tamoxifen-resistant cells to physiological levels of estrogen leads to cell death. Addition of the estrogen receptor downregulator fulvestrant prevents estrogen-induced death in a dose-dependent manner. Our data indicate that endogenous levels of estrogen affect the response of tamoxifen-resistant cells to fulvestrant. These results suggest that failure of fulvestrant to inhibit tumor growth in some tamoxifen-resistant patients may be due to endogenous estrogen levels. Moreover, these studies support short-term treatment with estrogen as a second-line hormonal therapy for tamoxifen-resistant breast cancer.