ESR1 and ovarian carcinoma: In addition, adipocyte-derived hormones such as leptin are associated with increased proliferation of ER-positive ovarian cancer cells, while ERα can be transcriptionally activated through the signal transducer and activator of transcription-3 (STAT3) signaling pathway, suggesting that both ER status and growth promoting properties of adipocytes need to be considered in obese ovarian cancer patients (Choi et al., 2011).