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29 pages, 7715 KB  
Article
Functional pH-Responsive Nanoparticles for Immune Reprogramming in MSS Colorectal Cancer via ER Stress-Induced Proteostasis Disruption, PD-L1-Targeting miRNA, and TLR7 Activation
by Yu-Li Lo, Hua-Ching Lin, Ching-Yao Li, Bryant Huang, Ching-Ping Yang, Hui-Yen Chuang and Tsui-Fen Chou
Pharmaceutics 2025, 17(11), 1503; https://doi.org/10.3390/pharmaceutics17111503 - 20 Nov 2025
Abstract
Background: Colorectal cancer (CRC), particularly the microsatellite-stable (MSS) subtype, remains largely unresponsive to immune checkpoint inhibitors (ICIs) due to immune escape, tumor-associated macrophage (TAM) enrichment, and cytokine-driven suppression that sustain a TAM-dominant tumor microenvironment (TME). To overcome these barriers, a pH-responsive solid lipid [...] Read more.
Background: Colorectal cancer (CRC), particularly the microsatellite-stable (MSS) subtype, remains largely unresponsive to immune checkpoint inhibitors (ICIs) due to immune escape, tumor-associated macrophage (TAM) enrichment, and cytokine-driven suppression that sustain a TAM-dominant tumor microenvironment (TME). To overcome these barriers, a pH-responsive solid lipid nanoparticle (SLN) system was engineered to co-deliver CB-5083 (a VCP/p97 inhibitor), miR-142 (a PD-L1-targeting microRNA), and imiquimod (R, a TLR7 agonist) for spatially confined induction of endoplasmic reticulum stress (ERS) and immune reprogramming in MSS CRC. Methods: The SLNs were coated with PEG–PGA for pH-triggered de-shielding and functionalized with PD-L1- and EGFR-binding peptides plus an ER-homing peptide, enabling tumor-selective and subcellular targeting. Results: The nanoplatform displayed acid-triggered PEG–PGA detachment, selective CRC/TAM uptake, and ER localization. CB-mediated VCP inhibition activated IRE1α/XBP1s/LC3II, PERK/eIF2α/ATF4/CHOP, and JNK/Beclin signaling, driving apoptosis and autophagy, while miR-142 suppressed PD-L1 expression and epithelial–mesenchymal transition markers. R facilitated dendritic cell maturation and M1 polarization. Combined CB + miR + R/SLN-CSW suppressed IL-17, G-CSF, and CXCL1, increased infiltration of CD4+ and CD8+ T cells, reduced Tregs and M2-TAMs, and inhibited tumor growth in CT-26 bearing mice. The treatment induced immunogenic cell death, reprogramming the TME into a T cell-permissive state and conferring resistance to tumor rechallenge. Biodistribution analysis confirmed tumor-preferential accumulation with minimal off-target exposure, and biosafety profiling demonstrated low systemic toxicity. Conclusions: This TME-responsive nanoplatform therefore integrates ERS induction, checkpoint modulation, and cytokine suppression to overcome immune exclusion in MSS CRC, representing a clinically translatable strategy for chemo-immunotherapy in immune-refractory tumors. Full article
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8 pages, 928 KB  
Brief Report
Real-World Effectiveness of Finerenone Added to SGLT2 Inhibitor and GLP-1 Receptor Agonist Therapy in Individuals with Type 2 Diabetes and Chronic Kidney Disease
by Afif Nakhleh, Khaled Khazim and Naim Shehadeh
J. Clin. Med. 2025, 14(22), 8209; https://doi.org/10.3390/jcm14228209 - 19 Nov 2025
Viewed by 167
Abstract
Background/Objectives: Recent randomized controlled trial evidence in adults with type 2 diabetes (T2D) and chronic kidney disease (CKD) indicates that adding finerenone to empagliflozin provides additive clinical benefit. A prespecified analysis demonstrates that this benefit is consistent irrespective of prior glucagon-like peptide-1 receptor [...] Read more.
Background/Objectives: Recent randomized controlled trial evidence in adults with type 2 diabetes (T2D) and chronic kidney disease (CKD) indicates that adding finerenone to empagliflozin provides additive clinical benefit. A prespecified analysis demonstrates that this benefit is consistent irrespective of prior glucagon-like peptide-1 receptor agonist (GLP-1 RA) use. We aimed to assess the effectiveness of adding finerenone to existing sodium-glucose cotransporter-2 inhibitor (SGLT2i) and GLP-1 RA therapy in a real-world setting. Methods: We performed a retrospective cohort study of adults with T2D and CKD from Maccabi Healthcare Services diabetes, endocrinology, and nephrology clinics in Haifa, Israel. Included individuals initiated finerenone between 1 August 2023, and 31 January 2025, and met the following criteria: estimated glomerular filtration rate (eGFR) of 25–60 mL/min/1.73 m2; urinary albumin-to-creatinine ratio (UACR) > 300 mg/g; and a history of ≥12 weeks of SGLT2i (empagliflozin or dapagliflozin) and GLP-1 RA (liraglutide, dulaglutide, or semaglutide) use prior to finerenone initiation. Outcomes were assessed at the last measurement taken within 26 ± 10 weeks of finerenone initiation. The primary outcome was adjusted percent change in log-transformed UACR from baseline to follow-up. Secondary outcomes were adjusted mean changes in eGFR and serum potassium. We used multiple linear regression models. Prespecified subgroup analyses examined the UACR change by age, sex, body mass index (BMI), baseline eGFR, and baseline UACR. Results: Fifty-one individuals were included in the study, with a mean age of 66.0 ± 9.5 years and a mean BMI 30.9 ± 5.2 kg/m2. The median eGFR was 45 mL/min/1.73 m2 (IQR 36–52), and the median UACR was 1001 mg/g (IQR 515–1599). 94% were receiving a renin–angiotensin system inhibitor. Finerenone was initiated at 10 mg/day and titrated to 20 mg/day in eight individuals. Over a median follow-up of 27 weeks, the adjusted percent change in UACR was −51.3% (p < 0.001), consistent across prespecified subgroups. The adjusted mean eGFR change was −3.92 mL/min/1.73 m2 (p < 0.001). Serum potassium increased by +0.34 mmol/L (p < 0.001). Conclusions: In adults with T2D and albuminuric CKD already receiving an SGLT2i and a GLP-1 RA, adding finerenone substantially reduced albuminuria. Full article
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28 pages, 5988 KB  
Article
Effect of Nano-Gefitinib on Solid Ehrlich Carcinoma via Targeting EGFR, RIPK2 Pathways, and Macrophage Reprogramming
by Neveen R. Ashoura, Hebatallah M. Saad, Enas I. El Zahaby, Alyaa R. Salama, Nihal E. Amer, Omnya Elhussieny, Hanan A. Edres, Hisham A. Nematalla and Salman A. A. Mohammed
Pharmaceuticals 2025, 18(11), 1747; https://doi.org/10.3390/ph18111747 - 17 Nov 2025
Viewed by 266
Abstract
Background/Objectives: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are a promising therapeutic avenue against mammary cancer. Thus, we investigated whether the EGFR inhibitor Nano-Gefitinib bilosome decreases Ehrlich tumor cells in a murine model, given that EGFR has been linked to carcinoma–macrophage crosstalk. [...] Read more.
Background/Objectives: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are a promising therapeutic avenue against mammary cancer. Thus, we investigated whether the EGFR inhibitor Nano-Gefitinib bilosome decreases Ehrlich tumor cells in a murine model, given that EGFR has been linked to carcinoma–macrophage crosstalk. Methods: Forty female mice were divided into control, Nano-Gefitinib, Ehrlich tumor and combination groups; the latter received Nano-Gefitinib treatment after tumor induction and lasted for 18 days. Results: Our results showed that Nano-Gefitinib ameliorated Ehrlich-induced hepatic injury, oxidative stress, and apoptosis in mice, as indicated by a significant reduction in serum level of hepatic enzymes, oxidative biomarkers (malondialdehyde and oxidized glutathione), total cholesterol, triglycerides, LDL, and BAX, along with an increase in antioxidant biomarkers, serum total protein, albumin, HDL, and hepatic antiapoptotic Bcl-2. A substantial reduction in tumor volume and size was noted in the combination group and was evidenced histopathologically by a reduction in tumor cell progression, mitotic activity, and giant cell formation. In addition, Nano-Gefitinib significantly inhibited EGFR/p-AKT/ERK1/2/RIPK2/NF-κB with subsequent suppression of TGF-triggered M2 macrophage reprogramming, evidenced by the lowered protein expression of the M2 surface markers CD163 and decreased M2 protein expression (Fizz1, MMPs, and VEGF). Additionally, Nano-Gefitinib significantly increased M1 macrophage phenotype, evidenced by the upregulation in the immunoexpression of the CD68, in addition to increasing CD8 and caspase-3 and decreasing CD4, with VEGF immunoreactivity in the combination group. Conclusions: Gefitinib biosomes encouraged macrophage polarization, apoptosis, and reduced inflammation, with a subsequent decrease in tumor volume. Full article
(This article belongs to the Section Pharmacology)
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14 pages, 1259 KB  
Article
Short-Term Laboratory Outcomes of SGLT2 Inhibitor Use in Type 2 Diabetic Patients: A Retrospective Analysis
by Hamood AlSudais, Turky AlSulaiman, Badi A. Alotaibi, Abdulrahman Alshalani, Abdulaziz M. Almuqrin, Rehab B. Albakr and Jehad A. Aldali
J. Clin. Med. 2025, 14(22), 7985; https://doi.org/10.3390/jcm14227985 - 11 Nov 2025
Viewed by 389
Abstract
Background: This retrospective study evaluated the short-term effects of the SGLT2 inhibitor Dapagliflozin on laboratory markers in patients with type 2 diabetes mellitus (T2DM) over six months. Methods: Data were obtained from electronic health records at the King Abdullah International Medical [...] Read more.
Background: This retrospective study evaluated the short-term effects of the SGLT2 inhibitor Dapagliflozin on laboratory markers in patients with type 2 diabetes mellitus (T2DM) over six months. Methods: Data were obtained from electronic health records at the King Abdullah International Medical Research Centre in Riyadh, Saudi Arabia. The study focused on adult T2DM patients who began Dapagliflozin treatment in 2023 or 2024 and underwent laboratory tests before, and six months after, starting treatment, resulting in 783 patients meeting the inclusion criteria. Results: Analysis revealed significant reductions in glycemic markers (p-value < 0.01). Hematological responses revealed divergent trends by sex: females showed increases in mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW) (p-value < 0.01), while males showed a marginal decrease in mean corpuscular hemoglobin (MCH) (p-value < 0.05). Mean corpuscular volume (MCV) significantly decreased for both sexes (p-value < 0.01). Renal assessments indicated a significant increase in sodium levels and a marginal decrease in eGFR in males (p-values < 0.001 and <0.05, respectively), and elevated blood urea nitrogen (BUN) in both sexes (p-value < 0.01). Hepatic markers showed a marginal increase in alkaline phosphatase (ALP) in both sexes, with a trend toward a reduction in aspartate aminotransferase (AST) in males (p-value < 0.05). No significant changes were noted in lipid profiles or other hepatic markers. Conclusions: Dapagliflozin treatment in T2DM patients results in significant improvements in glycemic control and alterations in certain laboratory markers, indicating its potential impact on metabolic outcomes. Further research is needed to explore the underlying mechanisms and long-term effects. Full article
(This article belongs to the Section Clinical Laboratory Medicine)
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13 pages, 1991 KB  
Article
Revisiting p53 Immunohistochemical Staining and Its Prognostic Implications in Advanced EGFR-Mutated Lung Adenocarcinoma
by Feng-Che Kuan, Shun-Fu Chang, Yao-Ren Yang, Yu-Ying Wu, Fen-Fen Chen, Kam-Fai Lee, Chen-Lin Chi, Meng-Hung Lin and Chung-Sheng Shi
Cancers 2025, 17(21), 3577; https://doi.org/10.3390/cancers17213577 - 5 Nov 2025
Viewed by 375
Abstract
Background/Objectives: TP53 mutations in advanced epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer could worsen prognosis. Therefore, we aimed to investigate the clinical significance of TP53 mutations and p53 expression in these patients. Methods: Patients with advanced/metastatic EGFR-mutated lung adenocarcinoma treated with [...] Read more.
Background/Objectives: TP53 mutations in advanced epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer could worsen prognosis. Therefore, we aimed to investigate the clinical significance of TP53 mutations and p53 expression in these patients. Methods: Patients with advanced/metastatic EGFR-mutated lung adenocarcinoma treated with first-line tyrosine kinase inhibitors were retrospectively enrolled. Sanger sequencing was performed to detect TP53 mutations and immunohistochemical staining was used to verify p53 protein expression levels. Kaplan-Meier and Cox proportional hazards analyses were used to estimate survival and hazard ratio (HR) with 95% confidence interval (CI). Results: The study involved 83 patients with adequate tumor samples for TP53/p53 analysis. Patients with tumor p53 immunostaining ≥50% showed significantly better overall survival (OS) (HR: 0.49 [95% CI: 0.30–0.81], p < 0.001), but TP53 mutations were not associated with inferior progression-free survival (PFS) or OS (missense vs. wild-type [PFS, HR: 0.68 (95% CI: 0.40–1.15), p = 0.151; OS, HR: 0.88 (95% CI: 0.56–1.42), p = 0.599]). Areas under the receiver operating characteristic curves of TP53 mutations with different cut-off values for p53 positivity were 0.51–0.56. The Kaplan-Meier survival analysis revealed significant survival benefits in patients with EGFR L858R substitution and tumor p53 immunostaining ≥50% (median PFS: 8.0 vs. 5.3; median OS: 20.4 vs. 15.3 months; log-rank p = 0.025 and 0.049, respectively). Conclusions: Tumor p53 immunostaining (≥50%) was associated with better OS, especially in patients with TP53 mutations or L858R. Prospective clinical trials are required to explore the prognostic significance of p53 expression in the genomic era of TP53 mutations. Full article
(This article belongs to the Section Cancer Biomarkers)
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20 pages, 3509 KB  
Article
Interventional Radiotherapy (Brachytherapy) Combined with Systemic Treatment—The Influence of RAS Gene Mutations and Combined Therapy on the Results and Toxicity of Colorectal Cancer Liver Metastases
by Paweł Cisek, Aleksandra Kozłowska and Ludmiła Grzybowska-Szatkowska
Cancers 2025, 17(21), 3530; https://doi.org/10.3390/cancers17213530 - 31 Oct 2025
Viewed by 262
Abstract
Introduction: The aim of the study was to analyse the results and potential complications of local treatment with HDR (high dose-rate) brachytherapy of liver metastases from colorectal cancer, depending on the targeted therapy used and considering RAS gene mutation and chemotherapy in individual [...] Read more.
Introduction: The aim of the study was to analyse the results and potential complications of local treatment with HDR (high dose-rate) brachytherapy of liver metastases from colorectal cancer, depending on the targeted therapy used and considering RAS gene mutation and chemotherapy in individual treatment lines. Material and methods: The study included 142 patients with oligoprogressive liver metastases who underwent HDR brachytherapy without changing the line of treatment, based on a retrospective analysis of 270 patients treated between 2015 and 2022. The impact of RAS gene mutations, lines of chemotherapy depending on the treatment regimens used, PFS (progression free survival), OS (overall survival), LC (local control) and the degree of radiological response were analysed. The impact of these drugs on hepatotoxicity and the risk of haemorrhagic complications was also analysed. Results: The presence of mutations in KRAS/NRAS genes (exons 2, 3, 4) had a statistically significant impact on PFS in the first, third and fourth lines of treatment, and on OS and LC in the third and fourth lines of treatment. In the third and fourth lines of treatment, patients with a mutation in the RAS gene had a poorer radiological response to treatment regardless of the chemotherapy used. PFS, OS and LC differed depending on the line of treatment and amounted to 17.5, 11, 8.5, 6 and 4 months, 27, 19, 13, 11 and 11 months, and 27, 19, 11, 6 and 6 months, respectively. The greatest benefit in terms of PFS was achieved by patients treated with first-line chemotherapy combined with epidermal growth factor receptor (EGFR) inhibitors, in the absence of RAS gene mutations. In the third line, the greatest benefit was achieved by patients treated with trifluridine/tipiracil in the absence of RAS gene mutations. The greatest percentage reduction in the volume of treated lesions and the highest percentage of control were observed in the first three lines of treatment. The toxicity of the treatment was low; only in the third and fourth lines of treatment were differences in the decrease in albumin levels found depending on the type of treatment used. Conclusions: A mutation in the RAS genes worsens the prognosis, regardless of the line of treatment and the systemic treatment used. The greatest benefit from brachytherapy is seen in patients in the first three lines of treatment without RAS mutations, treated with anti-EGFR chemotherapy in the first line and trifluridine/tipiracil in the third line. Combining brachytherapy of liver metastases with systemic treatment is safe, regardless of the systemic treatment used. Full article
(This article belongs to the Special Issue Advances in Brachytherapy in the Treatment of Tumors)
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20 pages, 339 KB  
Review
The Three Musketeers in Cancer Therapy: Pharmacokinetics, Pharmacodynamics and Personalised Approach
by Milan Zarić, Petar Čanović, Radica Živković Zarić, Simona Protrka and Miona Glišić
J. Pers. Med. 2025, 15(11), 516; https://doi.org/10.3390/jpm15110516 - 31 Oct 2025
Viewed by 586
Abstract
Cancer therapy is rapidly evolving from a one-size-fits-all paradigm toward highly personalized approaches. Traditional chemotherapies and radiotherapies, while broadly applied, often yield suboptimal outcomes due to tumor heterogeneity and are limited by significant toxicities. In contrast, precision oncology tailors prevention, diagnosis, and treatment [...] Read more.
Cancer therapy is rapidly evolving from a one-size-fits-all paradigm toward highly personalized approaches. Traditional chemotherapies and radiotherapies, while broadly applied, often yield suboptimal outcomes due to tumor heterogeneity and are limited by significant toxicities. In contrast, precision oncology tailors prevention, diagnosis, and treatment to the individual patient’s genetic and molecular profile. Key advancements underscore this shift: molecularly targeted drugs (e.g., trastuzumab for HER2-positive breast cancer, EGFR and ALK inhibitors for lung cancer) have improved efficacy and reduced toxicity compared to conventional therapy. Pharmacokinetic (PK) and pharmacodynamic (PD) considerations are central to personalizing treatment, explaining variability in drug exposure and response among patients and guiding dose optimization. Modern strategies like therapeutic drug monitoring and model-informed precision dosing seek to maintain drug levels in the therapeutic range, improving outcomes. Immunotherapies, including checkpoint inhibitors and CAR-T cells, have transformed oncology, though patient selection via biomarkers (such as PD-L1 expression or tumor mutational burden) is critical to identify likely responders. Innovative drug delivery systems, notably nanomedicine, address PK challenges by enhancing tumor-specific drug accumulation and enabling novel therapeutics. Furthermore, rational combination regimens (informed by PK/PD and tumor biology) are being designed to achieve synergistic efficacy and overcome resistance. Key barriers include the high cost of biomarker testing, insufficient laboratory infrastructure, and inconsistent reimbursement policies. Operational inefficiencies such as long turnaround times or lack of clinician awareness further limit the use of precision diagnostics. Regulatory processes also remain complex, particularly around the co-development of targeted drugs and companion diagnostics, and the evidentiary requirements for rare subgroups. Addressing these barriers will require harmonized policies, investment in infrastructure, and educational initiatives to ensure that the promise of personalized medicine becomes accessible to all patients. Ensuring that advances are implemented responsibly—guided by pharmacological insights, supported by real-world evidence, and evaluated within ethical and economic frameworks—will be critical to realizing the full potential of personalized cancer medicine. Full article
(This article belongs to the Section Personalized Medicine in Pharmacy)
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22 pages, 6134 KB  
Article
Novel Sulfated Oligosaccharide DP9 from Marine Algae, Gracilaria lemaneiformis: A Potent Galectin-3 Inhibitor for Pancreatic Cancer Therapy
by Pingting Liu, Fengyuan Li, Zhicong Liu and Yang Liu
Mar. Drugs 2025, 23(11), 423; https://doi.org/10.3390/md23110423 - 30 Oct 2025
Viewed by 537
Abstract
Galectin-3 (Gal-3) is a histologic marker of pancreatic cancer and a potential therapeutic target. This study aimed to characterize a novel sulfated agarose-derived oligosaccharide (DP9) from marine algae, Gracilaria lemaneiformis, evaluate its Gal-3 inhibitory activity, and investigate its anti-pancreatic cancer mechanisms. Through [...] Read more.
Galectin-3 (Gal-3) is a histologic marker of pancreatic cancer and a potential therapeutic target. This study aimed to characterize a novel sulfated agarose-derived oligosaccharide (DP9) from marine algae, Gracilaria lemaneiformis, evaluate its Gal-3 inhibitory activity, and investigate its anti-pancreatic cancer mechanisms. Through controlled acid hydrolysis, a series of odd-numbered oligosaccharides (DP3-11) were obtained, in which DP9 showed the strongest Gal-3 inhibition in hemagglutination assays. Structural analysis confirmed DP9’s unique composition including an alternating β (1→4)-D-galactose and α (1→3)-3,6-anhydro-L-galactose backbone, featuring partial 6-O-methylation on β-D-galactose and 6-O-sulfation on 3,6-anhydro-α-L-galactose residues. Molecular docking revealed DP9’s binding to Gal-3’s carbohydrate recognition domain through key hydrogen bonds (His158, Arg162, Lys176, Asn179 and Arg186) and hydrophobic interactions (Pro117, Asn119, Trp181 and Gly235), with the sulfate group enhancing binding affinity. In vitro studies demonstrated DP9’s selective anti-pancreatic cancer activity against BxPC-3 cells, including inhibition of cell proliferation; S-phase cell cycle arrest; induction of apoptosis; and suppression of migration and invasion. Mechanistically, DP9 attenuated the Gal-3/EGFR/AKT/FOXO3 signaling pathway while showing minimal cytotoxicity to normal cells. This study first demonstrated that agarose-derived odd-numbered oligosaccharides (DP9) can serve as effective Gal-3 inhibitors, which proved its potential as a marine oligosaccharide-based therapeutic agent for pancreatic cancer. Full article
(This article belongs to the Special Issue Marine-Derived Bioactive Substances and Their Mechanisms of Action)
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25 pages, 2502 KB  
Article
Synthesis, EGFR inhibitors, Crystal Structure, and Molecular Docking of 2-Amino-6-methoxy-4-(2-bromophenyl)-4H-benzo [h]chromene-3-carbonitrile
by Al-Anood M. Al-Dies
Crystals 2025, 15(11), 935; https://doi.org/10.3390/cryst15110935 - 30 Oct 2025
Viewed by 552
Abstract
A novel 4H-benzo[h]chromene derivative was efficiently synthesized and structurally characterized as a β-enaminonitrile. Single-crystal X-ray diffraction confirmed its molecular structure, revealing a stable crystal lattice stabilized by intermolecular N–H···N hydrogen bonds and π–π stacking. The compound was evaluated [...] Read more.
A novel 4H-benzo[h]chromene derivative was efficiently synthesized and structurally characterized as a β-enaminonitrile. Single-crystal X-ray diffraction confirmed its molecular structure, revealing a stable crystal lattice stabilized by intermolecular N–H···N hydrogen bonds and π–π stacking. The compound was evaluated for its inhibitory activity against both wild-type EGFR (EGFRWT) and the resistant T790M mutant (EGFRT790M). It exhibited moderate activity against EGFRWT (IC50 = 3.27 ± 0.72 μM) but demonstrated significantly enhanced potency against EGFRT790M (IC50 = 1.92 ± 0.05 μM), showing a low resistance factor compared to the reference drugs Erlotinib and Gefitinib. Comparative molecular docking studies against both wild-type and T790M mutant structures suggested that the compound maintains a stable binding mode involving key interactions with the hinge region residue Met769, rationalizing its ability to circumvent the T790M resistance mechanism. These findings identify the 4H-benzo[h]chromene scaffold as a promising lead for developing novel inhibitors to overcome EGFRT790M-mediated resistance. Full article
(This article belongs to the Section Organic Crystalline Materials)
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14 pages, 1981 KB  
Article
Protective Role of Thiamine Pyrophosphate Against Erlotinib-Induced Oxidative and Inflammatory Damage in Rat Optic Nerve
by Ezgi Karatas, Bulent Yavuzer, Ozlem Demir, Esra Tuba Sezgin, Engin Hendem, Emine Cinici, Taha Abdulkadir Coban and Halis Suleyman
Biomedicines 2025, 13(11), 2614; https://doi.org/10.3390/biomedicines13112614 - 25 Oct 2025
Viewed by 367
Abstract
Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) such as erlotinib are widely used in non-small-cell lung cancer treatment, and accumulating evidence indicates they can markedly increase ocular toxicity. Nonetheless, whether erlotinib causes optic nerve injury has not been investigated before and [...] Read more.
Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) such as erlotinib are widely used in non-small-cell lung cancer treatment, and accumulating evidence indicates they can markedly increase ocular toxicity. Nonetheless, whether erlotinib causes optic nerve injury has not been investigated before and remains a subject worth investigating. This study aimed to examine the impact of erlotinib on oxidative stress, inflammation, and histopathological changes in rat optic nerve tissue and evaluate the potential neuroprotective role of thiamine pyrophosphate (TPP). Methods: Twenty-four male Wistar rats were randomly assigned to four groups: healthy control, TPP alone, erlotinib alone, and erlotinib + TPP. Erlotinib (10 mg/kg, orally, on alternate days) and TPP (20 mg/kg, intraperitoneally, daily) were administered for two consecutive weeks. Optic nerve samples were analyzed for malondialdehyde (MDA), total glutathione (tGSH), superoxide dismutase (SOD), catalase (CAT), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α), followed by histopathological examination. Results: Erlotinib treatment significantly increased MDA, IL-1β, and TNF-α levels while reducing tGSH, SOD, and CAT activity, demonstrating oxidative stress and an inflammatory response. Co-administration of TPP ameliorated these changes by lowering reactive oxygen species, restoring antioxidant capacity, and attenuating inflammation. Histopathological alterations, including astrocyte degeneration, edema, and vascular congestion, were evident after erlotinib exposure but were significantly alleviated when TPP was administered concurrently. Conclusions: Erlotinib induces oxidative and inflammatory optic nerve injury, while TPP co-treatment offers significant neuroprotection. These findings support TPP as a potential adjunct to reduce EGFR-TKI-related ocular toxicity and highlight importance of redox modulation in limiting treatment-associated side effects. Full article
(This article belongs to the Special Issue Advanced Research in Neuroprotection)
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15 pages, 4863 KB  
Article
Estimated Glomerular Filtration Rate Variability in Patients with Diabetes Receiving SGLT2 Inhibitors Versus DPP4 Inhibitors
by Yi-Wei Kao, Tze-Fan Chao, Yu-Wen Cheng, Shao-Wei Chen and Yi-Hsin Chan
Pharmaceutics 2025, 17(11), 1370; https://doi.org/10.3390/pharmaceutics17111370 - 23 Oct 2025
Viewed by 438
Abstract
Background: Major clinical trials regarding sodium–glucose cotransporter 2 inhibitors (SGLT2is) have focused on estimated glomerular filtration rate (eGFR) slope and composite kidney outcomes, with limited evaluation of eGFR variability as a kidney outcome or its long-term implications in patients receiving SGLT2i versus placebo. [...] Read more.
Background: Major clinical trials regarding sodium–glucose cotransporter 2 inhibitors (SGLT2is) have focused on estimated glomerular filtration rate (eGFR) slope and composite kidney outcomes, with limited evaluation of eGFR variability as a kidney outcome or its long-term implications in patients receiving SGLT2i versus placebo. Methods: This retrospective study analyzed 3777 propensity score-matched patients with type 2 diabetes receiving either SGLT2i or dipeptidyl peptidase-4 inhibitor (DPP4i) between June 2016 and December 2021. Each patient had eGFR data at three time points before (−15, −9, and −3 months) and after (3, 9, and 15 months) the drug-index date. eGFR variability was assessed using the coefficient of variation (COV) and standard deviation (SD) of eGFR values. Results: SGLT2i therapy was associated with a significant reduction in eGFR variability by both COV (from 0.072 (0.001) to 0.069 (0.001); p = 0.014) and SD (mL/min/1.73 m2) (from 5.34 (0.07) to 4.82 (0.07); p < 0.001). In contrast, DPP4i therapy resulted in increased COV (from 0.072 (0.001) to 0.080 (0.001); p < 0.001) and no significant improvement in SD (from 5.06 (0.07) to 5.22 (0.07); p = 0.082). Greater reduction in eGFR variability was observed in SGLT2i relative to DPP4i with high pre-treatment eGFR variability, pre-existing chronic kidney disease, or rapid pre-treatment eGFR decline. Greater pre-treatment eGFR variability predicted risk of major adverse kidney events (MAKEs) and abrupt kidney decline in DPP4i-treated patients, but not in those on SGLT2is. SGLT2i consistently reduced the risk of MAKE and abrupt kidney decline across the spectrum of pre-treatment eGFR variability, with a greater risk reduction on the MAKE for SGLT2i versus DPP4i therapy with a higher pre-treatment eGFR variability estimated by SD (p interaction = 0.014). Conclusions: SGLT2i therapy improved eGFR variability and reduced the risk of adverse kidney outcomes compared to DPP4i, particularly in patients with higher pre-treatment eGFR variability. Full article
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21 pages, 4862 KB  
Article
Exploring the Therapeutic Potential of Moringa oleifera Against Lung Cancer Through Network Modeling and Molecular Docking Analysis
by Anuj Singh, Deepak Ohri, Olaf Wolkenhauer, Naveen Kumar Gautam, Shailendra Gupta and Krishna P. Singh
Int. J. Mol. Sci. 2025, 26(20), 10191; https://doi.org/10.3390/ijms262010191 - 20 Oct 2025
Viewed by 673
Abstract
Lung cancer remains the leading cause of cancer-related mortality worldwide, with significant resistance to conventional therapies, highlighting the urgent need for novel therapeutic strategies. Moringa oleifera (M. oleifera), a medicinal plant rich in diverse bioactive compounds, has shown promising potential for [...] Read more.
Lung cancer remains the leading cause of cancer-related mortality worldwide, with significant resistance to conventional therapies, highlighting the urgent need for novel therapeutic strategies. Moringa oleifera (M. oleifera), a medicinal plant rich in diverse bioactive compounds, has shown promising potential for anti-lung carcinoma activity. This study investigates the molecular mechanisms underlying the therapeutic effects of M. oleifera bioactive compounds for their anti-lung cancer activities through an integrated network modeling and molecular docking approach. By constructing comprehensive compound–target–lung cancer pathway networks, we aim to elucidate the multitarget pharmacology of M. oleifera compounds, providing valuable insights into their potential as therapeutic candidates. Computational pipeline was applied to identify 180 phytochemicals from M. oleifera, filtered using Lipinski’s Rule of Five and ADMET properties, resulting in 10 lead compounds followed by their potential biological target proteins in regulating lung cancer progression. We identified 80 targeted proteins involved in lung cancer, with EGFR being the most enriched in pathway enrichment analysis. In the molecular docking analysis, caffeic acid showed the highest binding score (−28.97 kcal/mol) with EGFR forming stable complex during molecular dynamics simulations compared to the known EGFR inhibitor ‘erlotinib’. The overall results suggest that caffeic acid, a key bioactive compound in M. oleifera, is an EGFR-mediated oncogenic signaling inhibitor for lung cancer therapy, warranting further experimental validation to translate these findings into clinical applications. Full article
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10 pages, 493 KB  
Article
Belatacept-Based Immunosuppression in Lung Transplant Recipients with Calcineurin Inhibitor Renal Toxicities
by Krysta Walter, Alisia Chen, Jennifer Hagopian, Elizabeth Belloli, Michael Combs, Dennis Lyu and Rommel Sagana
Transplantology 2025, 6(4), 31; https://doi.org/10.3390/transplantology6040031 - 19 Oct 2025
Viewed by 642
Abstract
Background/Objectives: Calcineurin inhibitors (CNI) contribute to renal dysfunction post-transplant. Belatacept is a renal sparing immunosuppressive agent. We sought to determine if the use of belatacept, as an alternative to a CNI-based maintenance immunosuppressive regimen ameliorates the effects of CNI-related nephrotoxicity in lung [...] Read more.
Background/Objectives: Calcineurin inhibitors (CNI) contribute to renal dysfunction post-transplant. Belatacept is a renal sparing immunosuppressive agent. We sought to determine if the use of belatacept, as an alternative to a CNI-based maintenance immunosuppressive regimen ameliorates the effects of CNI-related nephrotoxicity in lung transplant recipients, while preserving graft function. Methods: Retrospective case series of adult lung transplant recipients (LTR) converted to belatacept with CNI elimination between 2020 and 2023. Primary outcomes were estimated glomerular filtration rate (eGFR) and pulmonary function testing. Secondary outcomes included incidence of rejection, mortality, donor specific antibody (DSA), chronic lung allograft dysfunction, infection, malignancies, and drug discontinuation. Results: Five LTR converted to belatacept with a median follow up of 3.49 years (IQR 16.4). eGFR improved with a median change of +18 mL/min/1.73 m2 (IQR 6–34) at 12 months, this was sustained at last-follow-up (+19 mL/min/1.73 m2 (IQR 6–34)). Force expiratory volume in 1 s (FEV1) declined from baseline to last follow-up (median change −0.53 L). At a median of 199 days post-conversion (IQR 108–453), belatacept was discontinued in 4/5 (80%) LTR, primarily due to graft dysfunction (3/4), and CNI therapy resumed. No LTR developed CLAD, DSA, malignancy, or died on belatacept. Infection (primarily pulmonary bacterial or fungal) occurred in all LTR on belatacept. Conclusions: Belatacept with complete CNI elimination in LTR resulted in a sustained improvement in renal function in this series but was accompanied by a high discontinuation rate due to worsening graft function. The risks to the graft associated with belatacept and calcineurin inhibitor elimination outweigh any potential renal benefits. Full article
(This article belongs to the Section Solid Organ Transplantation)
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23 pages, 5795 KB  
Article
In Silico Network Pharmacology, Molecular Docking, and Molecular Dynamics Analysis of Rosemary-Derived Compounds as Potential HSP90 Inhibitors for Cancer Therapy
by Radhia Mazri, Mebarka Ouassaf, Afaf Zekri, Shafi Ullah Khan, Kannan R. R. Rengasamy and Bader Y. Alhatlani
Curr. Issues Mol. Biol. 2025, 47(10), 860; https://doi.org/10.3390/cimb47100860 - 18 Oct 2025
Viewed by 746
Abstract
Cancer remains a major global health challenge, emphasizing the need for new and effective therapies. This study investigates the anticancer potential of bioactive compounds from rosemary (Rosmarinus officinalis) using an integrative network pharmacology and computational approach. Twelve phytochemicals with favorable pharmacological profiles, optimal [...] Read more.
Cancer remains a major global health challenge, emphasizing the need for new and effective therapies. This study investigates the anticancer potential of bioactive compounds from rosemary (Rosmarinus officinalis) using an integrative network pharmacology and computational approach. Twelve phytochemicals with favorable pharmacological profiles, optimal pharmacokinetics, and acceptable toxicological properties were evaluated, revealing 178 putative cancer-related targets. Protein–protein interaction (PPI) analysis highlighted ten key genes—EGFR, ESR1, HIF1A, HSP90AA1, MAPK1, BCL2, STAT3, TP53, CASP3, and SRC—implicated in the progression of various cancers, including breast, colorectal, liver, and lung tumors. Functional enrichment analysis demonstrated their involvement in multiple cancer-associated pathways. Among these, HSP90AA1 emerged as a critical target. Molecular docking revealed Rosmanol, Chlorogenic acid, and Carnosol as the most promising HSP90AA1 binders with strong predicted affinities. ADMET profiling confirmed their excellent drug-likeness and safety profiles, while molecular dynamics simulations validated the stability of the compound–protein complexes, further supporting their potential as HSP90 inhibitors. These findings suggest that rosemary-derived compounds may represent valuable candidates for anticancer drug development, though experimental validation is required to confirm their therapeutic efficacy. Full article
(This article belongs to the Collection Bioinformatics Approaches to Biomedicine)
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11 pages, 1830 KB  
Article
Increased EGFR/HER2 Pathway Activation Contributes to Skin Tumorigenesis in Tpl2/− Mice
by Laura R. Purkey, Stefania Mehedincu, Charles Irvine, Raelyn Akdag, Megan Little, W. Wade Kothmann, Katharine Rus, Erin Greenberg, Neil Shady and Kathleen DeCicco-Skinner
Cancers 2025, 17(20), 3362; https://doi.org/10.3390/cancers17203362 - 18 Oct 2025
Viewed by 495
Abstract
Background: The mitogen-activated protein kinase (MAPK) signaling pathway is frequently dysregulated in cutaneous squamous cell carcinoma (cSCC). Tumor progression locus 2 (Tpl2), a serine/threonine protein kinase within the MAPK family, regulates cellular proliferation, survival, and inflammatory responses. Loss of Tpl2 activates [...] Read more.
Background: The mitogen-activated protein kinase (MAPK) signaling pathway is frequently dysregulated in cutaneous squamous cell carcinoma (cSCC). Tumor progression locus 2 (Tpl2), a serine/threonine protein kinase within the MAPK family, regulates cellular proliferation, survival, and inflammatory responses. Loss of Tpl2 activates compensatory signaling cascades, driving increased papilloma and cSCC development. In this study we examined whether dysregulated ErbB signaling contributes to the enhanced tumor burden found in Tpl2−/− mice. Methods: To evaluate whether aberrant ErbB signaling drives tumorigenesis in Tpl2−/− mice, wild-type (Tpl2+/+) and Tpl2−/− mice were subjected to a two-stage chemical carcinogenesis protocol for 48 weeks. A subset of mice received Gefitinib (an EGFR inhibitor) or Lapatinib (a HER2 inhibitor) in their diet. Results: We found that Tpl2 ablation increases gene expression of EGFR, HER2, and HER3, while baseline protein levels remain unchanged between Tpl2 genotypes. To investigate the possibility of microRNA (miR)-mediated post-transcriptional regulation of EGFR, HER2, and HER3, we measured ErbB-related miR expression in keratinocytes. We found that HER2/3-related miRs 205 and 21 are increased in Tpl2−/− keratinocytes. Further, Tpl2 loss enhances p-EGFR, EGFR, and HER2 protein expression in papillomas. and HER2-related microRNAs (miRs) 205 and 21 in keratinocytes, and enhances p-EGFR, EGFR, and HER2 protein expression in papillomas. Tpl2−/− mice developed 12-fold more papillomas and 4-fold more cSCCs compared to Tpl2+/+ animals. Treatment with Gefitinib or Lapatinib reduced papilloma numbers by 88% and 50%, respectively, while restoring cSCC numbers to Tpl2+/+ levels. Conclusions: These findings indicate that ErbB targeting represents a promising therapeutic strategy for cSCCs arising from MAPK pathway dysregulation. Full article
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