Eradication of Therapy-Resistant Cancer Stem Cells by Novel Telmisartan Derivatives

J Med Chem. 2025 Jan 9;68(1):287-306. doi: 10.1021/acs.jmedchem.4c01865. Epub 2024 Dec 18.

Abstract

The present structure-activity relationship study investigates the development of novel chemosensitizers targeting therapy-resistant cancer stem cells (CSCs). We used 4'-((2-propyl-1H-benzo[d]imidazole-1-yl)methyl)-[1,1'-biphenyl]-2-carboxylic acid, derived from the angiotensin II type 1 receptor blocker telmisartan, as a lead structure, demonstrating that the biphenyl moiety is essential for chemosensitizing activity. Introducing a methyl carboxylate or carboxamide instead of the COOH-group significantly enhanced this effect, leading to the development of highly potent compounds. These novel, noncytotoxic chemosensitizers effectively target CSCs and overcome drug resistance by interfering with CSC persistence mechanisms─hyperactivated STAT5 signaling and increased drug transporter activity─with demonstrated efficacy in leukemia, ovarian, and prostate cancers. The carboxamide of telmisartan (telmi-amide, 7c) significantly reduced tumor growth in an imatinib-resistant leukemia xenograft model, both as monotherapy and combined with imatinib, showing promising oral bioavailability and tolerability. In summary, telmisartan derivatives act as effective chemosensitizers and offer an innovative strategy for targeting CSCs in various malignant diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin II Type 1 Receptor Blockers / chemical synthesis
  • Angiotensin II Type 1 Receptor Blockers / chemistry
  • Angiotensin II Type 1 Receptor Blockers / pharmacology
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Animals
  • Antineoplastic Agents / chemical synthesis
  • Antineoplastic Agents / chemistry
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Benzimidazoles / chemical synthesis
  • Benzimidazoles / chemistry
  • Benzimidazoles / pharmacology
  • Benzimidazoles / therapeutic use
  • Benzoates / chemical synthesis
  • Benzoates / chemistry
  • Benzoates / pharmacokinetics
  • Benzoates / pharmacology
  • Benzoates / therapeutic use
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Drug Resistance, Neoplasm* / drug effects
  • Female
  • Humans
  • Male
  • Mice
  • Neoplastic Stem Cells* / drug effects
  • Structure-Activity Relationship
  • Telmisartan* / chemical synthesis
  • Telmisartan* / chemistry
  • Telmisartan* / pharmacology
  • Telmisartan* / therapeutic use
  • Xenograft Model Antitumor Assays

Substances

  • Telmisartan
  • Antineoplastic Agents
  • Benzoates
  • Benzimidazoles
  • Angiotensin II Type 1 Receptor Blockers