Overall
- Language
- English
- Conflict of Interest
- In relation to this article, we declare that there is no conflict of interest.
- Publication history
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Received September 26, 2025
Revised February 28, 2026
Accepted March 7, 2026
Available online July 25, 2026
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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.
Most Cited
Synergistic Antitumor Effects of Paclitaxel Combined with PDE5 Inhibitor Avanafil on Glioma U373 Cells
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.

