Background:
Ferroptosis is a novel form of regulated cell death, however, the potential functions of ferroptosis in the breast cancer (BRCA) prognosis, immune infiltration, and drug resistance remain unknown.
Methods:
In this study, the characteristic patterns of ferroptosis in estrogen receptor–positive (ER+) breast cancer were systematically investigated with the interactions between ferroptosis and the tumor microenvironment (TME). On the mRNA expression profiles of 56 ferroptosis-related genes (FRGs), two ferroptosis patterns were constructed, with distinct prognosis, immune cell infiltrations and tamoxifen resistance.
Results:
The high ferroptosis scores were characterized by better prognosis, increased immune cell infiltration, higher immune and stromal scores, lower tumor purity, lower tumor mutational burden (TMB) and better Tamoxifen response, immune-related pathways showed statistically significant activation, while pathways related to cell repair and metabolism showed significant inhibition.
Conclusion:
Collectively, ferroptosis could be involved in the diverse and complex TME. Evaluation of the ferroptosis patterns may heighten the comprehension about immune infiltrations in the TME, ferroptosis-related risk score model can predict the prognostic of ER + BRCA patients and for the treatment of resistance to tamoxifen administration and assisting oncologists to generate individualized immunotherapeutic strategies.