Asiatic acid as a leading structure for derivatives combining sub-nanomolar cytotoxicity, high selectivity, and the ability to overcome drug resistance in human preclinical tumor models.

Amides and rhodamine B conjugates of different pentacyclic triterpene acids have been shown outstanding cytotoxicity for human tumor cells. Starting from asiatic acid, a new rhodamine B hybrid has been synthesized, and its cytotoxic activity was investigated employing several human tumor cell lines (A375 (melanoma), HT29 (colorectal carcinoma), MCF7 (breast adenocarcinoma), A2780 (ovarian carcinoma), HeLa (cervical carcinoma), (NIH 3T3 (non-malignant murine fibroblasts). For these conjugates of this kind it has been established that the spacer attached to the carboxyl group at ring E governs the magnitude of the cytotoxicity. These asiatic acid - rhodamine B conjugates were highly cytotoxic for human tumor cell lines but also selective. For example, 7, an acetylated homopiperazinyl spacered rhodamine B conjugate, held an EC50  = 0.8 nM for A2780 ovarian carcinoma cells. Additional staining experiments showed the rhodamine B conjugates to act as mitocans and to effect apoptosis. In further tests using 3D spheroid models of colorectal- and mamma carcinoma, 7 demonstrated activity in the lower nanomolar range and the ability to overcome resistance to clinically used standard chemotherapeutic drugs. Therefore 7 induces cytotoxic effects leading to an equal response in the chemotherapy of both sensitive and resistant tumor models. Analyses of mitochondrial function and glycolysis and respiration derived ATP production confirmed compound 7 to act as mitocan but also revealed a rapid perturbation of the cellular energy metabolism as the primary mechanism of action, which is completely different to conventional chemotherapeutic drugs and thereby explains the ability of compound 7 to overcome chemotherapeutic drug resistance.