Advancements and Challenges in Anticancer Targeted Therapy with Small Molecules

A Special Issue of Biomedicines (ISSN 2227-9059) belonging to the section "Cancer Biology and Oncology".

Deadline for manuscript submissions: closed (31 July 2026) | Viewed by 6592

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Guest Editor
Department of Pharmacobiology, Pharmaceutical Faculty, Jagiellonian University Medical College, Kraków, Poland
Interests: antileukemic activity; polyphenols; KLF-4 signaling pathway; apoptosis; DNA damage; polyploid giant cancer cells
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Special Issue Information

Dear Colleagues,

Small molecules are chemical compounds with masses < 900 Da. Due to their small size, they easily penetrate the cell membrane and interact not only with membrane receptors but also with intracellular targets. They are easily distributed in the body and metabolized to an active drug. Small molecules constitute the majority of manufactured drugs and are mainly taken by patients orally.

Small molecules are successfully used as molecularly targeted drugs in the treatment of some cancers, as is the case with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors.

Small molecules have been developed for many therapeutic cancer targets. Examples include receptor tyrosine kinase inhibitors and non-receptor tyrosine kinase inhibitors, serine/threonine kinase inhibitors, proteasome inhibitors, inhibitors for epigenetic regulatory proteins, BCL-2 inhibitors, and matrix metalloproteinase inhibitors.

The great success achieved in the treatment of CML cannot be achieved in many other cancer diseases, possibly due to the heterogeneous expression of the therapeutic targets of cancer cells in patients. Another problem is resistance to therapy using small molecules, both existing ones and those acquired during treatment.

To solve these problems, we need to identify new predictive biomarkers, develop small molecules targeted at resistance mutations and cancer stem cells or use multitarget drugs.

This Special Issue will present research on new small molecules as molecular targeted therapies in cancer treatment, as well as research on new ways to bypass the problems of acquired resistance to small molecules. Research on new therapeutic targets is also welcome.

Dr. Monika Papiez
Guest Editor

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Keywords

  • small molecules
  • cancer
  • anticancer targeted therapy
  • cancer resistance
  • cancer growth blockers

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Published Papers (3 papers)

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Research

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22 pages, 22982 KB  
Article
Koumine’s Therapeutic Impact on Hepatocellular Carcinoma: A Combined Network Pharmacology and Experimental Study
by Hailing Lin, Yuli Tang, Lingfei Shi, Shengjie Zhu, Wenqiang Yan, Weihong Chen and Wancai Que
Biomedicines 2026, 14(6), 1250; https://doi.org/10.3390/biomedicines14061250 - 30 May 2026
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Abstract
Background: Koumine is a bioactive alkaloid derived from the traditional medicinal plant Gelsemium elegans. Although it has demonstrated anti-tumor effects in various cancers, its specific role and mechanism in hepatocellular carcinoma (HCC) remain unclear. This study aims to investigate the anti-HCC effects [...] Read more.
Background: Koumine is a bioactive alkaloid derived from the traditional medicinal plant Gelsemium elegans. Although it has demonstrated anti-tumor effects in various cancers, its specific role and mechanism in hepatocellular carcinoma (HCC) remain unclear. This study aims to investigate the anti-HCC effects of Koumine and elucidate the underlying molecular mechanisms. Methods: A network pharmacology approach was employed to predict potential targets and pathways of Koumine against HCC. The binding affinities between Koumine and core targets were validated using molecular docking. In vitro, the effects of Koumine on the proliferation, migration, and invasion of HCC cells were assessed, and the expression levels of key proteins were examined. In vivo, the anti-tumor efficacy and toxicity of Koumine were evaluated using a murine xenograft model. Results: Network pharmacology analysis identified 124 potential targets of Koumine against HCC, with 10 core targets (e.g., P38, JAK1, JAK2, GRB2) and key pathways involving MAP2K1, P38, JAK1, and MET being implicated. Molecular docking confirmed strong binding affinities between Koumine and these core targets. In vitro experiments demonstrated that Koumine dose-dependently inhibited the proliferation, migration, and invasion of HCC cells and modulated the expression and phosphorylation of P38. In vivo results showed that Koumine significantly suppressed tumor growth without causing notable toxicity. Conclusions: This study systematically reveals that Koumine exerts its anti-HCC effects by targeting the MAP2K1, P38, JAK1, JAK2, and MET signaling pathways. These findings highlight the potential of Koumine as a novel and safe therapeutic agent for the treatment of hepatocellular carcinoma. Full article
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Review

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17 pages, 1972 KB  
Review
Menin Inhibition in Acute Myeloid Leukemia: Pathobiology, Progress and Promise
by Utsav Joshi and Rory M. Shallis
Biomedicines 2026, 14(1), 219; https://doi.org/10.3390/biomedicines14010219 - 20 Jan 2026
Cited by 6 | Viewed by 2773
Abstract
Acute myeloid leukemia (AML) is a highly aggressive malignancy defined by significant biological diversity and variable patient outcomes. A key subset of AML is driven by abnormalities that lead to the overexpression of the oncogenic transcription factors HOXA9 and MEIS1. These abnormalities include [...] Read more.
Acute myeloid leukemia (AML) is a highly aggressive malignancy defined by significant biological diversity and variable patient outcomes. A key subset of AML is driven by abnormalities that lead to the overexpression of the oncogenic transcription factors HOXA9 and MEIS1. These abnormalities include KMT2A (formerly MLL) rearrangements and NPM1 mutations, as well as other rare lesions such as NUP98 rearrangements. This review focuses on the biology of the KMT2A, NPM1, and HOX/MEIS1 pathways, dissecting their molecular mechanisms of leukemogenesis. A central theme is the role of the scaffolding protein menin in the epigenetic regulation of this pathway, which ultimately drives malignant transformation. Currently, the clinical landscape is being transformed by the emergence of menin inhibitors as promising therapeutic agents for AML harboring these specific genetic anomalies. We evaluate the latest data on various menin inhibitors—both as monotherapy and in combinations—emphasizing their efficacy and safety profiles. As new evidence continues to accumulate with recent drug approvals and ongoing randomized, phase 3 studies, menin inhibitors are rapidly becoming a component of the AML treatment paradigm for relapsed/refractory and likely newly diagnosed disease. Full article
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18 pages, 841 KB  
Review
Cutaneous Adverse Events of Tyrosine Kinase Inhibitors in Endocrine Tumors: Clinical Features, Mechanisms, and Management Strategies
by Marta Marino, Francois Rosset, Alice Nervo, Alessandro Piovesan, Valentina Pala, Elisa Vaccaro, Luca Mastorino, Aldo E. Calogero and Emanuela Arvat
Biomedicines 2025, 13(12), 3044; https://doi.org/10.3390/biomedicines13123044 - 11 Dec 2025
Cited by 5 | Viewed by 2381
Abstract
Background: Tyrosine kinase inhibitors (TKIs) are crucial to treating endocrine-related malignancies, including advanced thyroid cancers and neuroendocrine tumors, but their benefit is tempered by cutaneous adverse events (CAEs) that impair adherence and quality of life. Objective: To summarize the dermatologic toxicities of TKIs [...] Read more.
Background: Tyrosine kinase inhibitors (TKIs) are crucial to treating endocrine-related malignancies, including advanced thyroid cancers and neuroendocrine tumors, but their benefit is tempered by cutaneous adverse events (CAEs) that impair adherence and quality of life. Objective: To summarize the dermatologic toxicities of TKIs used in endocrine oncology and provide practical, multidisciplinary guidance for prevention and management. Methods: Narrative synthesis of clinical trial reports, post-marketing studies, and specialty guidelines pertinent to lenvatinib, vandetanib, cabozantinib, and other commonly used TKIs, integrating dermatologic and endocrine perspectives on mechanisms and care pathways. Results: VEGFR-targeted TKIs frequently cause hand–foot skin reaction, xerosis, fissuring, paronychia, and impaired wound healing; multikinase inhibition also produces alopecia, pigmentary changes, and mucositis. Epidermal growth factor receptor (EGFR) and rearranged during transfection (RET) inhibition with vandetanib is associated with acneiform eruption, photosensitivity, and nail fragility. Pathogenesis reflects on-target inhibition of VEGF/EGFR signaling leading to keratinocyte dysfunction, vascular fragility, and altered eccrine mechanics. Early risk stratification, patient education, and bundle-based prophylaxis (emollients, keratolytics, urea-based creams, sun protection) reduce incidence and severity. Grade-based algorithms combining topical corticosteroids/antibiotics, dose interruptions or reductions, and short systemic courses (e.g., doxycycline, antihistamines) enable symptom control while maintaining anticancer intensity. Close coordination around procedures minimizes wound-healing complications. Conclusions: Dermatologic toxicities are predictable, mechanism-linked, and manageable with proactive, multidisciplinary care. Standardized prevention and treatment pathways tailored to specific TKIs—particularly lenvatinib, vandetanib, and cabozantinib—can preserve dose intensity, optimize quality of life, and sustain antineoplastic efficacy. Full article
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