Salinas-Vera, Yarely M., Gallardo-Rincón, Dolores, Ruíz-García, Erika, Silva-Cázares, Macrina B., de la Peña-Cruz, Carmen Sol, and López-Camarillo, César
Abstract: Endometrial cancer represents the most frequent neoplasia from the corpus uteri and comprisesthe 14th leading cause of death in women worldwide. Risk factors that contribute to the diseaseinclude early menarche, late menopause, nulliparity, and menopausal hormone use, as well as hypertensionand obesity comorbidities. The clinical effectiveness of chemotherapy is variable, suggestingthat novel molecular targeted therapies against specific cellular processes associated with the maintenanceof cancer cell survival and therapy resistance ameliorate the rates of success in endometrialcancer treatment. In the course of tumor growth, cancer cells must adapt to decreased oxygen availabilityin the microenvironment by upregulation of hypoxia-inducible factors, which orchestrate theactivation of a transcriptional program leading to cell survival. During this adaptative process, thehypoxic cancer cells may acquire invasive and metastatic properties as well as increased cell proliferationand resistance to chemotherapy, enhanced angiogenesis, vasculogenic mimicry, and maintenanceof cancer cell stemness, which contribute to more aggressive cancer phenotypes. Several studieshave shown that hypoxia-inducible factor 1 alpha (HIF-1α) protein is aberrantly overexpressed inmany solid tumors of the breast, prostate, ovarian, bladder, colon, brain, and pancreas. Thus, it hasbeen considered an important therapeutic target. Here, we reviewed the current knowledge of therelevant roles of cellular hypoxia mechanisms and HIF-1α functions in diverse processes associatedwith endometrial cancer progression. In addition, we also summarize the role of microRNAs in theposttranscriptional regulation of protein-encoding genes involved in the hypoxia response in endometrialcancer. Finally, we pointed out the need for urgent targeted therapies to impair the cellularprocesses activated by hypoxia in the tumor microenvironment.