ISSN: 0256-1115 (print version) ISSN: 1975-7220 (electronic version)
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In relation to this article, we declare that there is no conflict of interest.
Publication history
Received September 26, 2025
Revised February 28, 2026
Accepted March 7, 2026
Available online July 25, 2026
articles This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Synergistic Antitumor Effects of Paclitaxel Combined with PDE5 Inhibitor Avanafil on Glioma U373 Cells

Department of Pharmacy Services, Vocational School of Health Services, Bingol University 1Department of Chemistry, Faculty of Arts and Sciences, Bingol University 2Department of Biology, Faculty of Science, Atatürk University 3Plant and Animal Production Department, Technical Sciences Vocational School of Sivas, Sivas Cumhuriyet University 4Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Bingol University
kubrakc@hotmail.com, theburaktuzun@yahoo.com
Korean Journal of Chemical Engineering, July 2026, 43(9), 2455-2476(22)
https://doi.org/10.1007/s11814-026-00704-4

Abstract

Paclitaxel is a well-known chemotherapeutic agent that induces cancer cell death by stabilising microtubules. Avanafil, a 

phosphodiesterase type 5 (PDE5) inhibitor typically used for erectile dysfunction, has recently been proposed to enhance 

blood-brain barrier permeability. This research focuses on, for the first time, the role of avanafil used together with paclitaxel

to treat glioma. The cytotoxic effect of this combination on the U373 brain cancer cell was evaluated using MTT, 

colony survival analysis, and wound healing assay. Western blot analyses of the agents were conducted to investigate their 

effects on p53, Cas-3, Cas-9, Bax, Bcl-2, and c-PARP proteins. Additionally, Avanafil, Paclitaxel, and Avanafil+Paclitaxel 

combinations were calculated using the Gaussian package program at the B3LYP, HF, and M062x levels in the 6–31 g, 

6–31++g, and 6–31++g(d, p) basis sets. The activities of the agents against brain tumour proteins (PDB ID: 2DME and 

6YPE) were compared and their ADME/T properties were also investigated. MTT and colony survival analysis demonstrated

that the combination significantly inhibited U373 cell viability and proliferation. Wound healing and Western blot 

assays indicated impaired migration and altered expression of apoptosis-related proteins. Molecular docking and DFT 

analyses supported the experimental findings, and ADME/T profiling suggested favourable pharmacokinetics. Our results 

indicate that avanafil enhances the cytotoxicity of paclitaxel via non-apoptotic mechanisms, highlighting its potential as 

an adjuvant in glioma therapy.

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