Drugs Drug Candidates, Volume 5, Issue 1 (March 2026) – 23 articles

Background/Objectives: Hydrazones are organic compounds with the general structure R₂C=NNHR₁, distinguished by their versatility and modifiability, and are widely used in various applications due to their physicochemical and biological properties. They exhibit anticancer, anti-inflammatory, antibiofilm, and antibacterial activities. Antibiotic-resistant bacteria pose a serious public health threat, employing mechanisms such as enzymatic inactivation and efflux pumps. This study evaluated the antibacterial activity of the hydrazone HDZH1,4BENZ, a hydralazine-derived compound, as well as its potential adjuvant effect in combination with antibiotics against Staphylococcus aureus strains expressing efflux pumps. Methods: The strains used were 1199B (NorA efflux pump-expressing) and K2068 (MepA efflux pump-expressing). All assays were conducted using the broth microdilution method in Brain Heart Infusion (BHI) medium. Initially, the intrinsic antibacterial activity of the compound was determined. Subsequently, modulation assays were performed to evaluate its potential effect on efflux pump activity, with a standard efflux pump inhibitor included as a positive control. Results: Although HDZH1,4BENZ did not demonstrate significant direct antibacterial activity, the results indicate that this hydrazone exerts a notable inhibitory effect on the NorA (Norfloxacin resistance efflux pump A) and MepA (Multidrug efflux protein A) efflux pumps in S. aureus, thereby enhancing the efficacy of antibacterial agents. Conclusions: The activity of the hydrazone was comparable to that of chlorpromazine, suggesting that it may represent a promising alternative in the fight against antibiotic-resistant bacterial infections. Full article

Background/Objectives: Optimizing synthesis parameters is essential to ensure the quality and stability of nanostructures. This study aimed to optimize the synthesis of selenium nanoparticles (SeNPs) by chemical reduction, using sodium selenite (Na₂SeO₃), ascorbic acid (AA), and polyvinyl alcohol (PVA) at different concentrations, volumes, and molar ratios. The effects of reduction time, purification steps, and variations in the concentration of the precursor and reducing agent, as well as in the volume of the stabilizer, on the characteristics of SeNPs were investigated to ensure their long-term stability, maintenance of their properties, and biological applicability. Methods: The SeNPs were analyzed by UV/Vis absorption spectroscopy, Dynamic Light Scattering (DLS), and Transmission Electron Microscopy (TEM), and were also evaluated for antifungal activity against the SC5314 strain of Candida albicans. Results/Conclusions: Monodisperse SeNPs were obtained under high concentrations of Na₂SeO₃ and AA, short reduction time, higher volumes of PVA (2–4 mL), and purification at 24.300× g, presenting a spherical morphology, hydrodynamic diameter of 137.0–171.7 nm, dry diameter of 20–120 nm, polydispersity index of 0.049–0.306, Zeta potential of −7.79 to −19.6 mV, and stability for up to 180 days. In the absence or presence of 1 mL of PVA, the SeNPs were predominantly amorphous. Regarding biological activity, the SeNPs did not exhibit antifungal activity under the experimental conditions in the tested strain. Together, this study provides a comprehensive update on the synthesis of SeNPs under different conditions and their stability over time, contributing to the consolidation of knowledge in the field. Full article

Alzheimer’s disease is a progressive neurodegenerative disorder marked by cognitive decline, and its global prevalence is expected to increase substantially in the coming decades. This review examines current therapeutic approaches and explores the potential role of medicinal plants and natural products in the treatment and prevention of Alzheimer’s disease. This review examines the pathophysiology of Alzheimer’s disease, with particular emphasis on the cholinergic, amyloid, and tau hypotheses. It evaluates currently approved therapeutic approaches, including cholinesterase inhibitors and NMDA receptor antagonists, as well as emerging immunotherapies. In addition, this review provides a comprehensive analysis of the pharmacological properties of various medicinal plants and explores innovative drug delivery systems. Research reveals that while conventional drugs like donepezil and memantine provide symptomatic relief, they do not halt disease progression. Recent immunotherapies, including lecanemab and donanemab, show potential to reduce amyloid-beta accumulation and slow cognitive decline; however, they face safety concerns, such as amyloid-related imaging abnormalities, and high costs. By comparison, several natural products—including huperzine A, curcumin, resveratrol, and epigallocatechin-3-gallate—demonstrate multi-target therapeutic potential through anti-inflammatory, antioxidant, and cholinergic-modulating mechanisms. This review offers a comprehensive contrast between natural products and traditional drugs as well as the safety and economic limitations of immunotherapies. Given the multifactorial nature of AD, therapeutic strategies that address multiple pathological pathways appear necessary. In this regard, plant-derived compounds, due to their broad pharmacological activity and generally favorable safety profiles, emerge as promising candidates for long-term management and may contribute meaningfully to the development of future therapeutic approaches for AD. Full article

Background/Objectives: The study investigated the anti-inflammatory potential of neolignan derivatives of dehydrodieugenol (CP1–CP5), focusing on the inhibition of secretory phospholipase A2 (sPLA2), a key enzyme in inflammation. Methods: Comprehensive quantitative docking analysis using four independent algorithms (PLP, ASP, ChemScore, GoldScore) revealed exceptional multitarget binding profiles for CP1 and CP2, with scores consistently above activity thresholds for acetylcholinesterase (AChE), cyclooxygenase-2 (COX-2), and sPLA2 from Crotalus durissus terrificus in both monomeric (Mcdt) and quaternary (Tcdt) forms. Results: Among the compounds, CP1 demonstrated the highest predicted affinity (AChE: 78.5, COX-2: 83.8, sPLA2: 82.7–83.4) and most potent experimental activity, reducing sPLA2 catalytic velocity through mixed-type inhibition involving the active site (His47, Asp48) and Ca²⁺ binding loop. In vivo assays in sPLA2-induced paw edema demonstrated that CP1 and CP2 achieved remarkable anti-inflammatory effects (up to 68.3% reduction), significantly exceeding their protective potential by direct enzyme inhibition, confirming the multitarget mechanism. The strong correlation between predicted docking scores and paw edema reduction (R² = 0.89, p < 0.01) creates a firm foundation for establishing structure–activity relationship explanations. Conclusions: These findings highlight an integrated mechanism involving: (1) partial sPLA2 modulation, (2) neuroimmune regulation via AChE inhibition, and (3) prostaglandin synthesis blockade through COX-2 inhibition. This multitarget approach, combined with the natural origin of the compounds, positions dehydrodieugenol derivatives as promising candidates for developing therapies against complex inflammatory diseases, offering significant advantages over single-target strategies. Full article

The aim of this review is to analyze current routes for the administration and absorption of vitamin B12 in older adults, with a special focus on the sublingual route using orodispersible films, and evaluate the advances, materials, and challenges associated with this method of administration. Thus, the review aims to provide an updated overview of safe and effective alternatives for preventing and treating vitamin B12 deficiency in this age group. Vitamin B12 deficiency predominantly affects older adults. After the age of 70, absorption decreases, and deficiency occurs most frequently due to age-related gastric atrophy, decreased gastric acid production, reduced intrinsic factor secretion, and inadequate dietary vitamin B12 intake. This narrative review examines traditional and current treatments for vitamin B12 administration in older adults, with a focus on sublingual administration (SL) via orodispersible films (ODFs) to enhance absorption, adherence, and accessibility. SL vitamin B12 bioavailability, advantages versus disadvantages, ODF formulations (polymers such as pregelatinized starch, HPMC, and chitosan), and pharmaceutical process challenges (solvent casting and hot-melt extrusion) were explored in the reviewed in vitro and in vivo studies. According to the collected evidence, the sublingual route appears to offer rapid absorption directly into the bloodstream, with efficacy comparable to/superior to intramuscular (IM)/oral (OP) routes of administration, representing a patient-centered innovation for older adults that overcomes painful treatments and gastrointestinal/swallowing barriers. Future longitudinal clinical trials should validate long-term efficacy, standardize materials, and scale up to viable industrial production, addressing issues related to chemical stability and polypharmacy. Full article

Background: Prostate cancer is one of the most prevalent and deadly neoplasias in the male population. Despite the availability of therapies that increase the long-term survival of patients with localized tumors, metastatic prostate cancer is challenging to treat. A previous study revealed that the 2-aminopyridine derivative (named Neq0440) inhibited the PI3K-AKT-mTOR pathway and presented selective cytotoxicity toward the metastatic prostate cancer cell line PC-3. Methods: Here, we further analyzed the mechanism of action of these molecules by using cell-based colorimetric, fluorometric, epifluorescence microscopy, and Western blot assays. Results: Mitochondrial depolarization increased the AMPK level at 24 h inhibition with Neq0440, which led to the PI3K-AKT-mTOR pathway downregulation after 48 h. The phosphorylation was inhibited for AKT and the downstream quinases (S6RP and 4EBP1) from the PI3K-AKT-mTOR pathway, which can work together with the mitochondrial depolarization, lowering the pH of the medium, increasing ROS levels, and translocating the lysosomes toward the nucleus to trigger cell death. Conclusions: Therefore, Neq0440 can be used as a lead compound to obtain derivatives with a novel anticancer mechanism of action. Full article

Cancer metabolism is a cornerstone of tumor biology, characterized by profound alterations in cellular energy production and biosynthetic pathways that drive malignancy. The seminal discovery of the “Warburg effect”, the preference of cancer cells for aerobic glycolysis even under oxygen-rich conditions, provided the first major insight into this field. Historically, this observation was attributed to defective mitochondria, but modern research has revealed a far more complex picture of metabolic reprogramming that is actively driven by oncogenes, tumor suppressor genes, and the tumor microenvironment (TME). This review advances a unifying framework for understanding cancer metabolism as a dynamic ecosystem defined by three interconnected adaptations: metabolic plasticity, oncometabolite-driven epigenetic remodeling, and immune-metabolic crosstalk. These adaptations extend beyond glycolysis to encompass glutamine metabolism, lipid synthesis, amino acid utilization, and mitochondrial dynamics, all coordinated to fuel rapid proliferation, promote survival, and enable metastasis. By examining the drivers, consequences, and therapeutic barriers within this framework, we highlight emerging strategies for precision intervention. Although understanding the mechanistic basis of these pathways has unveiled new therapeutic avenues, clinical translation has been limited by metabolic redundancy, microenvironmental buffering, and patient heterogeneity. Strategies such as metabolic inhibitors, dietary interventions, and immuno-metabolic combinations offer promising prospects for disrupting tumor growth when guided by biomarker-driven patient selection and emerging technologies, including spatial metabolomics and AI-driven network modeling. Full article

Background: The growing recognition of shared molecular pathways and molecular signatures between cardiovascular diseases and cancer has motivated interest in exploring antihypertensive-associated chemical space for oncological applications. Concurrently, artificial intelligence (AI)-driven molecular generation has enabled the rapid creation of virtual lead candidates for specific therapeutic indications, although their broader biological interaction profiles often remain unexplored. Methods: In this paper, we explore the computational screening of a library of AI-generated antihypertensive virtual lead compounds to evaluate their polypharmacological anticancer potential. The compounds were originally designed and prioritized for modulating $\mathsf{\beta }$-adrenergic receptors but are here re-evaluated in a cancer-focused context using a multi-stage in silico approach. We chose five (5) known cancer target proteins and performed compound profiling for drug-likeness, pharmacokinetic suitability, and safety. Docking simulations, binding free energy estimates, molecular interaction mapping, and pharmacophore modeling were used to evaluate the molecules’ interactions with the cancer-linked protein targets. We employed the binding free energy estimates of the ligand–protein complexes to determine compounds with polypharmacological anticancer potential. In addition, molecular dynamics simulations of some of the compounds with polypharmacological anticancer potential were employed to evaluate binding stability and dynamic behavior of selected ligand–target complexes. Results: Several compounds showed good docking scores, physicochemical characteristics, and pharmacokinetic profiles. Also, the results reveal that several AI-generated antihypertensive virtual leads exhibit favorable multi-target binding profiles, with consistent docking affinities and stable interaction networks across multiple cancer-related targets. Conclusions: Our findings suggest that several of the hypothetically evaluated compounds exhibit favorable physicochemical properties, acceptable predicted pharmacokinetic and safety profiles, and consistent predicted binding affinities across multiple cancer-relevant targets. Full article

Chronic kidney disease (CKD) has emerged as a pervasive global health concern, for which there are no known curative treatments. Consequently, there is an imperative for the implementation of preventive and kidney-protective strategies. The renal kallikrein–kinin system (KKS) is a vasodilator, anti-inflammatory, and antifibrotic pathway located in the distal nephron, whose decline contributes to hypertension and CKD progression. In this narrative, non-systematic review, a thorough evaluation of both experimental and clinical data was undertaken to ascertain the interactions between dietary potassium, renal KKS activity, and kidney protection. A particular emphasis was placed on animal models of proteinuria, tubulointerstitial damage, and salt-sensitive hypertension, in conjunction with human studies on potassium intake and renal outcomes. A body of experimental evidence suggests a relationship between potassium-rich diets and renal kallikrein synthesis, urinary kallikrein activity, and up-regulated kinin B2 receptor expression. Collectively, these factors have been shown to result in reduced blood pressure, oxidative stress, apoptosis, inflammation, and fibrosis, and these effects are counteracted by B2 receptor blockade. In humans, higher potassium intake has been shown to enhance kallikrein excretion and lower cardiovascular and renal risk, independently of aldosterone. Conversely, low potassium intake has the potential to exacerbate CKD progression. Notwithstanding the concerns that have been raised regarding the potential necessity of increasing potassium intake in cases of advanced CKD, extant evidence would appear to indicate that potassium excretion persists until late disease stages. The activation and preservation of the renal KKS through a potassium-rich diet is a rational, cost-effective strategy for renoprotection. When combined with sodium reduction and nutritional education, this approach has the potential to halt the progression of CKD and enhance cardiovascular health on a population scale. Full article

Background/Objectives: Cephalosporins represent one of the most important classes of β-lactam antibiotics, widely used in clinical practice due to their broad-spectrum activity and favorable safety profile. As generations evolved, structural modifications were introduced to expand antimicrobial coverage and overcome β-lactamase resistance. This study aimed to analyze the drug-like properties of cephalosporins across different generations using molecular descriptors to identify structural and pharmacokinetic patterns influencing bioavailability and oral administration profiles. Methods: Thirty-eight cephalosporins representative of different generations were selected. Molecular data were obtained from PubChem, and SMILES were extracted and validated. Molecular descriptors (including MW, logP, TPSA, HBA, HBD, rotatable bonds, and global complexity indices) were calculated using the SwissADME and ChemDes platforms. Statistical analysis included ANOVA followed by post hoc tests, and principal component analysis (PCA). Results: A progressive increase in molecular weight, polarity, and TPSA was observed across generations, with fourth-generation cephalosporins showing significantly higher values compared to first-generation compounds (p < 0.0001). LogP decreased significantly in fourth-generation agents (p < 0.0001), reflecting increased polarity. PCA revealed that most compounds from generations 1–2 cluster in regions consistent with Lipinski’s and Veber’s rules, whereas fourth- and fifth generation - cephalosporins deviated substantially, prioritizing antimicrobial efficacy over oral bioavailability. Recurrent structural modifications such as oximes, tetrazoles, and aminothiazoles were identified, with increasing frequency in modern generations. Conclusions: The evolution of cephalosporins reflects a strategic shift toward enhanced antimicrobial potency and β-lactamase stability at the expense of oral bioavailability. Understanding these structural transitions provides valuable insights for rational drug design, aiming to balance antimicrobial effectiveness with favorable pharmacokinetic profiles essential for therapeutic success. Full article

Background/Objectives: The widespread development of anthelmintic resistance in gastrointestinal nematodes constitutes a major production-limiting factor in grazing ruminants. Resistance mechanisms often involve drug efflux transporters like P-glycoprotein (P-gp). This study aimed to evaluate the potential of the phytochemicals cinnamaldehyde (CNM) and thymol (TML) to modulate P-gp activity and enhance the pharmacokinetic profile and efficacy of levamisole (LVM) in lambs. Methods: An ex vivo diffusion assay using sheep ileum was conducted to assess the influence of CNM, TML, and LVM on the transport of the P-gp substrate Rhodamine 123 (Rho123). Subsequently, a clinical trial was performed in lambs naturally infected with resistant nematodes. Animals received LVM (3.75 mg/kg) subcutaneously, either alone or co-administered with CNM or TML (80 mg/kg). Plasma LVM concentrations were analyzed by HPLC, and anthelmintic efficacy was determined via the Fecal Egg Count Reduction (FECR) test. Results: Ex vivo assays demonstrated that CNM, TML and LVM significantly reduced the efflux ratio of Rho123, confirming P-gp inhibition. The pharmacokinetic parameters of LVM did not differ significantly in the co-administered groups. However, the combination of LVM + TML tended to increase the total systemic exposure of LVM. Although all experimental groups showed a significant reduction in EPG between day 0 and day 7 (FECR 50–58%), the magnitude of this reduction did not differ significantly among treatments. Conclusions: While CNM and TML effectively inhibited P-gp activity ex vivo and slightly modified LVM pharmacokinetics, these effects were insufficient to yield clinically meaningful improvements in its efficacy against nematodes under the tested conditions. Future strategies should focus on optimizing delivery systems to maximize phytochemical–drug interactions. Full article

Background: Phytocannabinoids such as cannabidiol (CBD) and cannabigerol (CBG) have received increasing attention in the context of inflammatory and intestinal disorders. However, direct comparisons between their individual and combined effects, as well as the influence of delivery systems, remain limited. Objectives: This study evaluated the biological effects of free and nanoencapsulated CBD and CBG, including a cannabinoid–Eudragit L100 formulation, in an in vitro TNBS-treated intestinal cell model and an in vivo murine model of TNBS-induced colitis. Methods: Cytotoxicity and treatment-associated effects of CBD, CBG, their 1:1 combination, and a nanoencapsulated formulation were assessed in TNBS-exposed Caco-2 cells. In parallel, BALB/c mice with TNBS-induced colitis were evaluated for colonic damage and inflammatory markers. Results: CBD and CBG individually showed dose-dependent effects in Caco-2 cells, while their combined administration produced a greater effect than either compound alone at higher concentrations. The nanoencapsulated formulation preserved cellular metabolic activity following TNBS exposure. In vivo, both free combined and nanoencapsulated cannabinoids were associated with reduced epithelial damage and inflammatory alterations. Conclusions: Nanoencapsulation using Eudragit L100 modulated the biological effects of CBD and CBG in experimental models of TNBS-induced intestinal injury. Full article

Oxidative stress, caused by an imbalance between the production of reactive oxygen species and endogenous antioxidant capacity, is a key etiological factor in numerous pathologies, including neurodegenerative and cardiovascular diseases. The limited clinical efficacy of conventional antioxidants is primarily due to their insufficient accumulation within the mitochondria, the main site of intracellular ROS generation. This article reviews the design and application of Mitochondria-Targeted Antioxidants, which represent a major advance in precision medicine. The design of these compounds involves linking an antioxidant “payload” to a lipophilic cation, such as the triphenylphosphonium group. This positive charge leverages the negative electrochemical gradient across the inner mitochondrial membrane to drive the antioxidant into the organelle. This mechanism allows the drug to reach concentrations over 100 times higher than non-targeted alternatives. The discussion encompasses the structure-activity analysis of the carrier, the payload (e.g., quinone derivatives), and the linker, which determine optimal subcellular partitioning and scavenging efficiency. Preclinical data highlight the therapeutic potential of this approach, showing strong neuroprotection in models of Parkinson’s and Alzheimer’s diseases, as well as improved outcomes in cardiovascular and ocular health. By restoring redox balance specifically within the mitochondria, these targeted therapies offer a more effective way to treat chronic oxidative damage. Full article

Background/Objectives: Recent reports have demonstrated the antiparasitic activity of 1,4-dihydropyridine (1,4-DHPs). This study aimed to assess the in vitro antischistosomal activity of 24 1,4-DHPs against Schistosoma mansoni adult worms. Methods: Sixteen hexahydroquinolines (1–16) and eight Hantzsch esters (17–24) previously obtained through a multicomponent Hantzsch reaction were tested in vitro against Schistosoma mansoni adult worms. In silico studies with the most active compounds were also carried out. Results: Among the tested compounds, the Hantzsch esters 20 (diethyl 4-(4-bromophenyl)-2,6-dimethyl-1,4-dihydropyridine-3,5-dicarboxylate) and 21 (diethyl 4-(3-fluorophenyl)-2,6-dimethyl-1,4-dihydropyridine-3,5-dicarboxylate) provided the lowest IC₅₀ (15.2 and 13.1 µM, respectively) and the highest selectivity for this parasite (SI = 2.31 and >4.59, respectively). Conclusions: Docking studies revealed that compound 21 has a high affinity for the S. mansoni target (PDB ID: 6UY4). Furthermore, ADMET predictions indicated that compound 21 meets the drug-likeness criteria without violating any Lipinski, Veber, or Egan’s rules. Full article

Background/Objectives: Periodontal disease is a condition marked by the destruction of tooth-supporting tissues, driven by an exaggerated immune response to an unbalanced dental biofilm. Conventional treatments struggle due to antimicrobial resistance and the biofilm’s protective extracellular matrix. This study evaluates the potential of bacteriophages as an innovative strategy for managing periodontal disease. Methods: This research employed a qualitative approach using Discursive Textual Analysis, with IRAMUTEQ version 0.8 alpha 7 (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) software. The search was conducted in the Orbit Intelligence and PubMed databases, for patents and scholarly articles, respectively. The textual data underwent Descending Hierarchical Classification, Correspondence Factor Analysis, and Similarity Analysis to identify core themes and relationships between words. Results: The analysis revealed an increase in research and patent filings concerning phage therapy for periodontal disease since 2017, emphasizing its market potential. The primary centers for intellectual property activity were identified as China and the United States. The study identified five focus areas: Genomic/Structural Characterization, Patent Formulations, Etiology, Therapeutic Efficacy, and Ecology/Phage Interactions. Lytic phages were shown to be effective against prominent pathogens such as Fusobacterium nucleatum and Enterococcus faecalis. Conversely, the lysogenic phages poses a potential risk, as they may transfer resistance and virulence factors, enhancing pathogenicity. Conclusions: Phage therapy is a promising approach to address antimicrobial resistance and biofilm challenges in periodontitis management. Key challenges include the need for the clinical validation of formulations and stable delivery systems for the subgingival area. Future strategies, such as phage genetic engineering and data-driven cocktail design, are crucial for enhancing efficacy and overcoming regulatory hurdles. Full article

The landscape of oncologic therapies has undergone large changes since the introduction of monoclonal antibody (mAb) based immunotherapies in the late 1990s and early 2000s. MAb-based therapeutics, also called biologics or large molecules, have distinct pharmacological characteristics compared to chemotherapeutics and small molecules. Development of biologics requires thorough assessment of pharmacokinetic (PK) and pharmacodynamic (PD) characteristics to ensure safety and demonstration of efficacy. This review provides an overview of the clinical pharmacology packages of biologics for the treatment of oncologic malignancies approved by the U.S. Food and Drug Administration (FDA) over the past decade (January 2015 and August 2025). The conduct of population PK (PopPK) and exposure-eesponse (E-R) analyses, as well as assessments for drug–drug interactions (DDIs), immunogenicity, and QT prolongation risk are discussed. The aim of this review is to provide insight into the clinical pharmacology assessments for approval of antibody-based therapies in oncology as well as provide a longitudinal view of clinical pharmacology packages in this space. Full article

Background/Objectives: β-Lapachone and triapine are compounds with recognized antitumor potential—the former is an ortho-naphthoquinone, and the latter a thiosemicarbazone inhibitor of ribonucleotide reductase. This study aimed to synthesize and evaluate new β-lapachone-based thiosemicarbazones (TSC1–TSC6) as potential antineoplastic agents. Methods: Lapachol was isolated from Tabebuia sp. and used to obtain ortho-naphthoquinones (2–4), which served as precursors for thiosemicarbazones (TSC1–TSC6). NMR and HRMS spectra were used to characterize the compounds. Their cytotoxic activity was evaluated in vitro against murine melanoma (B16–F10), colon carcinoma (CT26.WT), and breast cancer (4T1) cell lines, as well as normal fibroblasts (L929). Pharmacokinetic parameters were predicted in silico using ADMETLab 3.0. Results: β-Lapachone exhibited strong cytotoxicity toward tumor cells with moderate effects on normal cells, while thiosemicarbazones of β-lapachone, TSC1, and TSC3 demonstrated lower potency but greater selectivity. The β-lapachone-3-sulfonic acid showed high activity against melanoma and breast cancer cells and low toxicity toward normal cells, indicating tumor selectivity. In contrast, their thiosemicarbazones, TSC2, TSC4, and TSC6, showed weak or no antiproliferative activity. The 3-iodo-β-lapachone was cytotoxic to both tumor and normal cells, whereas its derivative TSC5 demonstrated moderate activity with reduced toxicity. β-Lapachone, β-lapachone-3-sulfonic acid, TSC1, and TSC3 exhibited favorable ADME profiles (QED ≈ 0.61–0.66), suggesting good oral bioavailability. Conclusions: The β-lapachone-3-sulfonic acid and the β-lapachone-based thiosemicarbazones TSC1 and TSC3 emerged as promising lead candidates, combining tumor selectivity, favorable pharmacokinetic properties, and structural innovation for the development of safer and more effective antineoplastic agents. Full article