Fig. 7: A proposed working model for the tumor-promoting role of the ERα-UBE2M positive feedback loop in ERα-positive breast cancer.

UBE2M forms a positive feedback loop with ERα. ERα enhances the HIF-1α-mediated transcription of UBE2M, and UBE2M in turn maintains ERα expression via UBE2M-CUL3/4A-E6AP-ERα axis. Silencing of UBE2M suppresses the growth of breast cancer cells by inducing cell cycle arrest and apoptosis and improves their sensitivity to fulvestrant both in vitro and in vivo.