ELF3 (E74 like ETS transcription factor 3) is an ETS family transcription factor that regulates gene expression by binding to ETS consensus sequences containing GGA[AT] cores. ELF3 functions as a transcriptional activator for multiple target genes and can form regulatory complexes with other transcription factors like EHF to enhance transcription of genes such as RAD51, which strengthens homologous recombination repair pathways 1. The protein plays critical roles in epithelial cell differentiation and demonstrates context-dependent oncogenic or tumor suppressive functions across different cancer types 2. In lung adenocarcinoma, ELF3 is upregulated in advanced tumor cells and responds to inflammatory cytokines by activating PI3K/Akt/NF-κB signaling, leading to increased expression of proliferation and anti-apoptosis genes like BCL2L1 and CCND1 3. ELF3 also promotes SPINK1 transcription in hepatocellular carcinoma through direct promoter binding, contributing to tumor dedifferentiation and chemoresistance 4. Genomic alterations in ELF3 have been identified as significantly altered genes in biliary tract cancers and are associated with peritoneal metastasis risk in gastric cancer 56. ELF3 expression is also elevated in diabetic nephropathy, suggesting roles beyond cancer biology 7.