Zosuquidar is a novel and potent P-glycoprotein (P-gp; Ki=59nM) inhibitor and multidrug resistance (MDR) modulator. Zosuquidar can be used in research related to acute myeloid leukemia (AML) and multidrug-resistant tumors[1-4].
In vitro, Zosuquidar (10.0μM) was co-incubated with 1-(hydroxymethyl)-3,4-dimethoxy-9H-xanthen-9-one (OX6; 20.0μM) in everted intestinal sacs for 5–45 minutes. Zosuquidar blocked the OX6-induced increase in Rhodamine 123 efflux[5]. Zosuquidar (0.3μM) was co-treated with chemotherapeutic agents in P-gp-expressing leukemia cell lines (K562/HHT40, K562/HHT90, K562/DOX, HL60/DNR) and primary AML blasts for 48 hours. Zosuquidar significantly enhanced the cytotoxicity of chemotherapeutic agents and restored cellular drug sensitivity[6].
In vivo, Zosuquidar (90mg/kg; once daily) was administered orally to BALB/c nude mice bearing NCI-H292 cells for 10 days. Zosuquidar significantly reduced PD-L1 expression in tumors[7]. Zosuquidar (5mg/kg or 25mg/kg; three times a week) was combined with Birinapant (3mg/kg or 10mg/kg; administered 5 hours after the third Zosuquidar injection; once weekly) via intraperitoneal injection in hepatitis B virus (HBV)-infected C57BL/6 mice for three consecutive weeks. Zosuquidar enhanced Birinapant-mediated death of HBV-positive hepatocytes and improved the kinetics of HBV-DNA and HBsAg control[8].
References:
[1] Cripe LD, Uno H, Paietta EM, et al. Zosuquidar, a novel modulator of P-glycoprotein, does not improve the outcome of older patients with newly diagnosed acute myeloid leukemia: a randomized, placebo-controlled trial of the Eastern Cooperative Oncology Group 3999. Blood. 2010 Nov 18;116(20):4077-85.
[2] Dantzig AH, Shepard RL, Cao J, et al. Reversal of P-glycoprotein-mediated multidrug resistance by a potent cyclopropyldibenzosuberane modulator, LY335979. Cancer Res. 1996 Sep 15;56(18):4171-9.
[3] Fan X, Guo D, Li S, et al. Fusidic Acid Reverses Chemoresistance in Breast Cancer via Targeting DDX6 to Downregulate GSK-3β/β-Catenin Signaling. Adv Sci (Weinh). 2025 Oct;12(39):e04680.
[4] Seaman S, Zhu Z, Saha S, et al. Eradication of Tumors through Simultaneous Ablation of CD276/B7-H3-Positive Tumor Cells and Tumor Vasculature. Cancer Cell. 2017 Apr 10;31(4):501-515.e8.
[5] Martins E, Silva V, Lemos A, et al. Newly Synthesized Oxygenated Xanthones as Potential P-Glycoprotein Activators: In Vitro, Ex Vivo, and In Silico Studies. Molecules. 2019 Feb 15;24(4):707.
[6] Tang R, Faussat AM, Perrot JY, et al. Zosuquidar restores drug sensitivity in P-glycoprotein expressing acute myeloid leukemia (AML). BMC Cancer. 2008 Feb 13;8:51.
[7] Ding L, Guo H, Zhang J, et al. Zosuquidar Promotes Antitumor Immunity by Inducing Autophagic Degradation of PD-L1. Adv Sci (Weinh). 2024 Nov;11(41):e2400340.
[8] Morrish E, Mackiewicz L, Silke N, et al. Combinatorial Treatment of Birinapant and Zosuquidar Enhances Effective Control of HBV Replication In Vivo. Viruses. 2020 Aug 17;12(8):901.
















