# Novel Active Homo-Aza (Lactam) Steroidal Antimetabolites for the Treatment of Human Pancreatic and Colorectal Cancer

**Authors:** Konstantinos E. Alifieris, Panagiotis Dalezis, Sofia Sagredou, Ioanna A. Anastasiou, Maria Deligiorgi, Christos Siokatas, Nikolaos Spanakis, Konstantinos Almpanakis, Maria Voura, Kyriakos Orfanakos, Mihalis Panayiotidis, Vasiliki Sarli, Dimitrios T. Trafalis

PMC · DOI: 10.3390/ph19020331 · 2026-02-17

## TL;DR

Researchers developed new steroidal drugs that show promise in treating pancreatic and colorectal cancers by targeting specific enzymes and inducing cell death.

## Contribution

The study introduces novel lactam steroidal antimetabolites with dual enzyme inhibition and strong preclinical efficacy.

## Key findings

- CS23 showed potent antiproliferative activity and induced apoptosis in cancer cells.
- CS23 exhibited high binding affinity for thymidylate synthase and dihydrofolate reductase.
- Strong correlations were found between docking scores and biological activity of the compounds.

## Abstract

Background: Colorectal and pancreatic cancers remain therapeutically challenging, with limitations in efficacy and limitations due to toxicity from conventional antimetabolites such as 5-fluorouracil (5-FU), methotrexate (MTX), and gemcitabine (GEM). Steroidal conjugation offers an approach to enhance selectivity and toxicokinetics. Methods: Five novel hybrid homo-aza (lactam) steroidal antimetabolites (GE23, CS18, CS23, KA44, MV16) were synthesized and tested against three pancreatic and four colorectal carcinoma cell lines with distinct molecular characteristics. Antiproliferative activity (MTT), apoptosis (Annexin V/PI), and cell cycle effects were assessed. Thymidylate synthase (TS) and dihydrofolate reductase (DHFR) inhibition was examined via molecular docking, Western blot, and enzymatic assays. Correlations between docking binding scores (DBS) and biological data were analyzed, and effects were compared with reference drugs (5-FU, MTX, GEM). Results: CS23, CS18, and KA44 exhibited the most potent cytostatic activity (mean GI50 10–80 µM). CS23 also induced high cytocidal effects, strong apoptosis (40% at 72 h), and G1/S arrest. Moreover, docking predicted the high binding affinity of CS23 for both TS (−11.2 kcal/mol) and DHFR (−11.5 kcal/mol), which was validated by Western blot and enzymatic inhibition (IC50 ≈ 20 nM). Correlation analyses showed significant relationships between hybrid steroidal antimetabolites’ cytostatic efficacy and DBS for TS (r = −0.75) and DHFR (r = −0.76), and combined DBS values predicted growth inhibition (r = −0.81, p < 0.01). No simple, universal correlation with single mutations of KRAS, BRAF, PI3K, or TP53 was found. Conclusions: Lactam steroidal antimetabolite hybrids, particularly CS23, act as dual TS/DHFR inhibitors, inducing apoptosis and cell cycle arrest with improved selectivity. Their strong in silico–in vitro concordance provides a compelling preclinical rationale for further evaluation of steroidal antimetabolites as next-generation therapeutics for resistant gastrointestinal malignancies.

## Linked entities

- **Genes:** KRAS (KRAS proto-oncogene, GTPase) [NCBI Gene 3845], BRAF (B-Raf proto-oncogene, serine/threonine kinase) [NCBI Gene 673], PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) [NCBI Gene 5290], TP53 (tumor protein p53) [NCBI Gene 7157]
- **Chemicals:** 5-fluorouracil (PubChem CID 3385), methotrexate (PubChem CID 4112), gemcitabine (PubChem CID 60750), CS23 (PubChem CID 70701901), CS18 (PubChem CID 6539304)
- **Diseases:** colorectal cancer (MONDO:0005575), pancreatic cancer (MONDO:0005192)

## Full-text entities

- **Genes:** PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) [NCBI Gene 5290] {aka CCM4, CLAPO, CLOVE, CWS5, HMH, MCAP}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, TF (transferrin) [NCBI Gene 7018] {aka HEL-S-71p, PRO1557, PRO2086, TFQTL1}, MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, MAPK1 (mitogen-activated protein kinase 1) [NCBI Gene 5594] {aka ERK, ERK-2, ERK2, ERT1, MAPK2, NS13}, KRAS (KRAS proto-oncogene, GTPase) [NCBI Gene 3845] {aka 'C-K-RAS, C-K-RAS, CFC2, K-RAS2A, K-RAS2B, K-RAS4A}, MAP2K7 (mitogen-activated protein kinase kinase 7) [NCBI Gene 5609] {aka JNKK2, MAPKK7, MEK, MEK 7, MKK7, PRKMK7}, POTEF (POTE ankyrin domain family member F) [NCBI Gene 728378] {aka A26C1B, POTE2alpha, POTEACTIN}, ZHX2 (zinc fingers and homeoboxes 2) [NCBI Gene 22882] {aka AFR1, RAF}, ANXA5 (annexin A5) [NCBI Gene 308] {aka ANX5, CPB-I, ENX2, HEL-S-7, PP4, RPRGL3}, EGF (epidermal growth factor) [NCBI Gene 1950] {aka HOMG4, URG}, DHFR (dihydrofolate reductase) [NCBI Gene 1719] {aka DHFR1, DYR}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, BRAF (B-Raf proto-oncogene, serine/threonine kinase) [NCBI Gene 673] {aka B-RAF1, B-raf, BRAF-1, BRAF1, NS7, RAFB1}, TYMS (thymidylate synthetase) [NCBI Gene 7298] {aka DKCD, HST422, TMS, TS}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, KDR (kinase insert domain receptor) [NCBI Gene 3791] {aka CD309, FLK1, VEGFR, VEGFR2}, GLP1R (glucagon like peptide 1 receptor) [NCBI Gene 2740] {aka GLP-1, GLP-1-R, GLP-1R}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}
- **Diseases:** gastrointestinal malignancies (MESH:D005770), lymphomas (MESH:D008223), necrosis (MESH:D009336), hepatocellular carcinoma (MESH:D006528), Colorectal and pancreatic cancers (MESH:D015179), leukemias (MESH:D007938), deaths (MESH:D003643), cytotoxic (MESH:D064420), hematologic malignancies (MESH:D019337), gastrointestinal and pancreatic adenocarcinoma (MESH:D010190), injury to (MESH:D014947), pancreatic (MESH:D010195), Maybe cancer (MESH:D009369), mitochondrial failure (MESH:D051437)
- **Chemicals:** pralatrexate (MESH:C418863), Na2CO3 (MESH:C005686), nucleoside (MESH:D009705), purine (MESH:C030985), cyclopentane (MESH:D003517), cladribine (MESH:D017338), LiOH (MESH:C028467), benzylamine (MESH:C030796), steroid (MESH:D013256), pyrimidines (MESH:D011743), NaH (MESH:C025451), glutamine (MESH:D005973), Ara-C (MESH:D003561), CO2 (MESH:D002245), reversine (MESH:C484369), THF (MESH:C030371), N-iodosuccinimide (MESH:C008155), reactive oxygen species (MESH:D017382), saponins (MESH:D012503), folate (MESH:D005492), glycosides (MESH:D006027), 4-dimethylaminopyridine (MESH:C003885), cannabinoids (MESH:D002186), pteridine (MESH:D011621), DMSO (MESH:D004121), (benzotriazol-1-yloxy)tris(dimethylamino)phosphonium (MESH:C031032), SRI-9439 (MESH:C462881), Hydrogen (MESH:D006859), FdUMP (MESH:D005468), Trp (MESH:D014364), Tween (MESH:D011136), GEM (MESH:D000093542), halogen (MESH:D006219), PBS (MESH:D007854), acetate (MESH:D000085), oxime (MESH:D010091), HEPES (MESH:D006531), formamide (MESH:C031066), penicillin (MESH:D010406), pyridine (MESH:C023666), phenylboronic acid (MESH:C010686), 6-thioguanine (MESH:D013866), (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MESH:C022616), nitrosureas (MESH:D009607), sulfur (MESH:D013455), 1,4-dioxane (MESH:C025223), cisplatin (MESH:D002945), Asn64 (-), acetic anhydride (MESH:C031800), carbohydrate (MESH:D002241), Pd(OAc)2 (MESH:C516071), 6-mercaptopurine (MESH:D015122), Phe (MESH:D010649), aminopterin (MESH:D000630), thymidine (MESH:D013936), trimetrexate (MESH:D016597), amino acid (MESH:D000596), MTT (MESH:C070243), NADPH (MESH:D009249), hydroxylamine hydrochloride (MESH:D019811)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Mutations:** 3140A>G, p.G12R, A3 adenosine, p.R273H, Glu30 (C-H), Gly30, G13D, 34G>C, 3151G>A, G12V, 151G>T, p.D211G, Glu30, 1799T>A, 1345C>A, Gly217 (C-H), Gly217, 844C>T, 632A>G, 1636C>A, p.H1047R, c.375+5G>T, p.E1051K
- **Cell lines:** LS174T — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_1384), HTau-29 — Homo sapiens (Human), Amyotrophic lateral sclerosis 1, Induced pluripotent stem cell (CVCL_8999), CS18 — Mus musculus (Mouse), Hybridoma (CVCL_C6V4), HT-29 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0320), GE23 — Epinephelus awoara (Yellow grouper), Spontaneously immortalized cell line (CVCL_S930), PANC 03.27 — Homo sapiens (Human), Pancreatic adenocarcinoma, Cancer cell line (CVCL_1635), SW403 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0545), MRC-5 — Homo sapiens (Human), Finite cell line (CVCL_0440), PANC 08.13 — Homo sapiens (Human), Pancreatic ductal adenocarcinoma, Cancer cell line (CVCL_1638), CCD-112CoN — Homo sapiens (Human), Finite cell line (CVCL_6382), LoVo — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0399), FHC — Homo sapiens (Human), Spontaneously immortalized cell line (CVCL_3688), KA44 — Homo sapiens (Human), Lung small cell carcinoma, Cancer cell line (CVCL_7023), CS23 — Cairina moschata (Muscovy duck), Transformed cell line (CVCL_S510), MV16 — Homo sapiens (Human), Amelanotic melanoma, Cancer cell line (CVCL_W280), CRL-1541 — Sigmodon hispidus (Hispid cotton rat), Spontaneously immortalized cell line (CVCL_YD58), CCL-171 — Mus musculus (Mouse), Undefined cell line type (CVCL_M023), HUP-T3 — Homo sapiens (Human), Pancreatic adenocarcinoma, Cancer cell line (CVCL_1299)

## Figures

31 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12944281/full.md

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Source: https://tomesphere.com/paper/PMC12944281