Background:Diffuse Gastric Cancer (DGC) is a highly aggressive form of gastric cancer
with a poor prognosis. Oxaliplatin (OX) is one of the first-line chemotherapeutic agents for the
treatment of gastric cancer. However, some patients with DGC do not benefit from OX therapy.
Resibufogenin (RBF), one of the main active components of the Chinese medicine Huachansu,
has demonstrated significant anti-cancer effects. Nevertheless, the potential of RBF to enhance the
sensitivity of OX treatment in DGC and its underlying mechanisms have not been reported.Objective:The aim of this study is to investigate the sensitizing effect of RBF on OX therapy for
DGC, as well as to elucidate the potential targets and mechanisms of action. This exploration is of
significant importance for the development of sensitizers that can improve the therapeutic efficacy
of OX and for the advancement of patentable innovations in this field.Methods:MTT assay, flow cytometry, Western blotting, and immunofluorescence assays were
employed to assess the inhibitory effects of Resibufogenin (RBF) in combination with OX on
DGC in vitro. Human DGC cell xenografts were established in a mouse model to evaluate the efficacy
and safety of RBF and OX for treating DGC in vivo.Results:It was found that RBF inhibited the proliferation of DGC cells in a time- and dose-dependent
manner. When RBF was used in combination with OX, the sensitivity of DGC cells to OX
was improved. Significantly, the combination of OX and RBF acts synergistically to induce apoptosis
and autophagy while inhibiting migration and invasion of DGC cells in vitro. In vivo, the
combination of OX and RBF dramatically inhibited the progression of DGC in the subcutaneous
xenograft model without observable toxicity. Mechanistically, RBF significantly inhibited the expression
and activation of FAK. OX and RBF synergistically inhibited the phosphorylation of
FAK, AKT, and GSK3β to abrogate the entry of β-catenin into the cell nucleus.Conclusion:RBF exhibits a pronounced suppressive effect on FAK, and its combination with OX
synergistically blocks the FAK/AKT/GSK3β/β-catenin signaling cascade, thereby inhibiting the
growth and metastasis of DGC. This study provides a novel avenue for future research and patent
development of FAK inhibitors, with the potential to enhance the therapeutic efficacy of DGC
treatment and overcome drug resistance.