30Abnormal expression of the progesterone receptor (PGR) isoforms, PGRA and PGRB, is 31 often observed in women with reproductive tract cancer. To assess the importance of the PGR 32 isoform ratio in the maintenance of the healthy reproductive tract, mice with Cre recombinase-33 activated PGRA and PGRB transgenes were bred with the PGR Cre mouse model to generate 34 strains expressing either PGRA or PGRB in PGR positive tissues. The PGRB mice developed 35 ovarian neoplasms at 23 weeks of age derived from ovarian luteal cells, while the PGRA 36 expressing mice displayed a reduced frequency of tumor development. Transcriptomic analyses 37 of the ovarian tumors revealed an enhanced AKT pathway signature, which is in agreement with 38 expression changes found in human ovarian adenocarcinoma. Effective treatment with the PGR 39 antagonist RU486 reduced tumor growth and the expression of cell cycle genes. We concluded 40 that tumor growth and proliferation is hormone and PGR isoform dependent. Further analysis of 41 the PGRB cistrome identified binding events of critical mitotic phase entry genes. This work 42 suggests an intriguing mechanism whereby the expression of the PGR isoforms determines in 43 vivo neoplasia through high-jacking of the cell cycle pathway. 44 45 Proper functioning of the reproductive tract depends on the appropriate signaling and 46 expression of the hormone receptors and their ligands for pregnancy and the maintenance of a 47 healthy fertile state 1 . Disruption of hormone signaling not only results in infertility and 48 miscarriage, but also can lead to diseases such as leiomyoma, endometriosis, and reproductive 49 tract cancer 2 . Endometrial cancer and ovarian cancer collectively contribute to over 37,000 50 deaths per year in the United States 3 . Further understanding of hormone signaling in the 51 reproductive tract, especially as it relates to the initiation and progression of disease, can 52 accelerate the development of specialized therapies to treat these diseases and cancers. 53 The ovary produces the female steroid hormones, estrogen and progesterone under the 54 direction from gonadotropins secreted from the pituitary gland 1 . These hormones function by 55 binding to their cognate receptors, the estrogen and progesterone receptors, to elicit activation or 56 repression of their respective target genes. The progesterone receptor (PGR) is expressed in all 57 uterine compartments, yet is limited to the pre-ovulatory granulosa cells of the ovary 4 . PGR 58 function is further regulated through the unique expression of different isoforms 5,6 . Genetically 59 engineered mice have been generated with specific ablation of both isoforms: PGRAKO and 60 PGRBKO. Phenotypic analysis of these mice demonstrated that the PGRA isoform is critical for 61 female mouse fertility. The PGRBKO mice were fertile with normal ovulation and embryo 62 implantation, yet displayed a mammary gland phenotype of altered ductal epithelial 63 proliferation 7 . The only uterine phenotype attributed to the PGRB...