Although paclitaxel (Taxol) is an active chemotherapeutic agent for the treatment of breast cancer, not all breast tumors are sensitive to this drug. In particular, there is a wide agreement on the low sensitivity of estrogen receptor (ER) a-positive breast cancer to paclitaxel treatment. However, the ERa-based insensitivity to paclitaxel is still elusive. Here, the effect of the E2/ERa-dependent upregulation of neuroglobin (NGB), an antiapoptotic globin, on the reduced sensitivity of breast cancer cells to paclitaxelinduced apoptosis has been evaluated in ERa-containing MCF-7 cells. The E2 pretreatment enhances the ERa activity and significantly impairs paclitaxel-induced apoptosis as evaluated by Annexin V assay and PARP-1 cleavage. NGB displays a pivotal role in the E2/ERa-induced antiapoptotic pathway to abrogate paclitaxel-induced cell death in stable NGB-silenced MCF-7 cell clones. Moreover, in the absence of the active ERa, paclitaxel significantly reduces the NGB cell content. In conclusion, these results highlight the involvement of ERa activation and of E2/ERa-dependent NGB upregulation in the insensitivity of MCF-7 to paclitaxel. These novel findings could have important implications in the development of targeted therapeutics for overcoming paclitaxel insensitivity in ERa-positive human breast cancer. V C 2016 IUBMB Life, 68(8): [645][646][647][648][649][650][651] 2016