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Compared with traditional therapies, targeted therapy has merits in selectivity, efficacy, and tolerability. Small molecule inhibitors are one of the primary targeted therapies for cancer. Due to their advantages in a wide range of targets, convenient medication, and the ability to penetrate into the central nervous system, many efforts have been devoted to developing more small molecule inhibitors. To date, 88 small molecule inhibitors have been approved by the United States Food and Drug Administration to treat cancers. Despite remarkable progress, small molecule inhibitors in cancer treatment still face many obstacles, such as low response rate, short duration of response, toxicity, biomarkers, and resistance. To better promote the development of small molecule inhibitors targeting cancers, we comprehensively reviewed small molecule inhibitors involved in all the approved agents and pivotal drug candidates in clinical trials arranged by the signaling pathways and the classification of small molecule inhibitors. We discussed lessons learned from the development of these agents, the proper strategies to overcome resistance arising from different mechanisms, and combination therapies concerned with small molecule inhibitors. Through our review, we hoped to provide insights and perspectives for the research and development of small molecule inhibitors in cancer treatment. Small molecule inhibitors have been permitted to be used in post‐line therapy, first‐line treatment, and adjuvant therapy. Compared with post‐line and first‐line treatment, attempts at adjuvant therapy are just beginning. Several factors should be considered in the adjuvant setting, including other standard treatments, subsequent therapy, financial benefit ratio, and treatment‐related side effects.

There is an urgent need to develop new targeted treatment agents for small cell lung cancer (SCLC). Tinengotinib (TT‐00420) is a novel, multi‐targeted, and spectrally selective small‐molecule kinase inhibitor that has shown significant inhibitory effects on certain solid tumors in preclinical studies. However, its role and mechanism of action in SCLC remain unclear. In this study, we demonstrated that tinengotinib effectively inhibited SCLC cell proliferation, especially highly expressing NeuroD1 (SCLC‐N), in the SCLC cell line‐derived xenograft (CDX) model and the malignant pleural effusion cell model of patients with SCLC. When combined with etoposide/cisplatin, it synergistically inhibited SCLC growth. Tinengotinib regulates proliferation, apoptosis, migration, cell cycle and angiogenesis in SCLC cells. Mechanistic studies revealed that c‐Myc expression may be a key factor influencing the effect of tinengotinib in SCLC‐N. This study provides reliable preclinical data and a new direction for tinengotinib as a promising therapy for SCLC, either alone or in combination with chemotherapy. Tinengotinib, a multi‐targeted kinase inhibitor, demonstrates significant efficacy in inhibiting small cell lung cancer (SCLC) cell proliferation, particularly in the SCLC‐N subtype with high NEUROD1 expression. When combined with etoposide/cisplatin, it synergistically suppresses SCLC growth. The study suggests tinengotinib as a promising therapeutic option, either alone or in combination with chemotherapy, addressing the urgent need for improved treatments in SCLC.

N6‐methyladenosine (m6A) modification, installed by METTL3‐METTL14 complex, is abundant and critical in eukaryotic mRNA. However, its role in oral mucosal immunity remains ambiguous. Periodontitis is a special but prevalent infectious disease characterized as hyperinflammation of oral mucosa and bone resorption. Here, it is reported that genetic deletion of Mettl3 alleviates periodontal destruction via suppressing NLRP3 inflammasome activation. Mechanistically, the stability of TNFAIP3 (also known as A20) transcript is significantly attenuated upon m6A modification. When silencing METTL3, accumulated TNFAIP3 functioning as a ubiquitin‐editing enzyme facilitates the ubiquitination of NEK7 [NIMA (never in mitosis gene a)‐related kinase 7], and subsequently impairs NLRP3 inflammasome assembly. Furtherly, Coptisine chloride, a natural small‐molecule, is discovered as a novel METTL3 inhibitor and performs therapeutic effect on periodontitis. The study unveils a previously unknown pathogenic mechanism of METTL3‐mediated m6A modifications in periodontitis and indicates METTL3 as a potential therapeutic target. N6‐adenosine‐methyltransferase‐like 3 (METTL3) mediated m6A modification plays a pivotal role in periodontitis. Mechanistically, METTL3 installs m6A modification on the TNFAIP3 transcript and facilitates its degradation. TNFAIP3 is found to bind with NEK7 and catalyze its ubiquitination, thus suppressing NLRP3 inflammasome assembly and activation. Meanwhile, the natural compound Coptisine chloride is discovered as a novel inhibitor of METTL3.

P38 mitogen‐activated protein kinase (p38MAPK) is a multifunctional protein kinase that plays an important role in human normal physiological activities and a variety of major diseases, and its signaling pathway affects a variety of regulatory factors in vivo, which is related to cell cycle, survival, metabolism, and differentiation. The four subtypes of p38MAPK have significant differences in their distribution, content, and effects in the body. The inhibitors of the four subtypes play potential roles in regulating cancer, neurodegenerative diseases, inflammation, and cardiovascular diseases, making it an attractive target for drug development. So far, an increasing number of p38MAPK inhibitors have been developed for targeted therapy in diseases, among which some representative compounds have entered clinical trials. Therefore, this review aims to provide a summary of the structural characteristics, signaling pathways of P38MAPK and the relationship between p38MAPK and disease, along with an overview of the binding modes and structure–activity relationships of small molecule inhibitors targeting four p38MAPK subtypes, and summarizes the challenges about the development of p38MAPK inhibitors, hoping to provide a valuable reference for the development and application of novel inhibitors.

T‐cell lymphoma (TCL) poses a significant challenge in clinical oncology, characterized by its aggressive behavior and resistance to conventional therapies. Despite considerable research efforts, the prognosis for TCL patients remains poor, primarily due to the lack of effective therapeutic strategies that can inhibit tumor progression and metastasis. In this study, we identified CaMKII‐α as a potential therapeutic target for TCL. To explore its role in TCL pathogenesis, we investigated its effects on TCL cell lines. Protein expression levels within the PI3K‐AKT signaling pathway were assessed using western blot analysis. Through siRNA‐mediated gene silencing, we downregulated CaMKII‐α expression and monitored TCL cell proliferation. Furthermore, we identified Evans Blue (IC50 = 197.1 nM) as a selective small‐molecule inhibitor of CaMKII‐α through high‐throughput screening (HTS). Evans Blue demonstrated significant tumor‐suppressive effects, potentially inhibiting TCL cell proliferation via regulation of the PI3K‐AKT signaling pathway. Notably, the antitumor effect of Evans Blue was comparable to that observed with genetic CaMKII‐α ablation, highlighting its potential as a novel therapeutic strategy for the treatment of TCL.

Objectives Autophagy, a highly conserved lysosomal degradation process in eukaryotic cells, has been widely reported closely related to the progression of many types of human cancers, including LGG; however, the intricate relationship between autophagy and LGG remains to be clarified. Materials and methods Multi‐omics methods were used to integrate omics data to determine potential autophagy regulators in LGG. The expression of ZFP36L2 and RAB13 in SW1088 cells was experimentally manipulated using cDNAs and small interfering RNAs (siRNA). RT‐qPCR detects RNAi gene knockout and cDNA overexpression efficiency. The expression levels of proteins in SW1088 cells were evaluated using Western blot analysis and immunofluorescence analysis. Homology modelling and molecular docking were used to identify compounds from Multi‐Traditional Chinese Medicine (TCM) Databases. The apoptosis ratios were determined by flow cytometry analysis of Annexin‐V/PI double staining. We detect the number of autophagosomes by GFP‐MRFP‐LC3 plasmid transfection to verify the process of autophagy flow. Results We integrated various omics data from LGG, including EXP, MET and CNA data, with the SNF method and the LASSO algorithm, and identified ZFP36L2 and RAB13 as positive regulators of autophagy, which are closely related to the core autophagy regulators. Both transcription level and protein expression level of the four autophagy regulators, including ULK1, FIP200, ATG16L1 and ATG2B, and LC3 puncta were increased by ZFP36L2 and RAB13 overexpression. In addition, RAB13 participates in autophagy through ATG2B, FIP200, ULK1, ATG16L1 and Beclin‐1. Finally, we screened multi‐TCM databases and identified gallic acid as a novel potential RAB13 inhibitor, which was confirmed to negatively regulate autophagy as well as to induce cell death in SW1088 cells. Conclusion Our study identified the key autophagic regulators ZFP36L2 and Rab13 in LGG progression, and demonstrated that gallic acid is a small molecular inhibitor of RAB13, which negatively regulates autophagy and provides a possible small molecular medicine for the subsequent treatment of LGG. The two positive autophagy regulators ZFP36L2 and RAB13 in Low‐grade Glioma patients were discovered by SNF method and Lasso method, and it was demonstrated that gallic acid can negatively regulate autophagy by inhibiting RAB13 for future LGG therapeutics.

Intervertebral discs (IVD) degeneration, which is caused by ageing or mechanical stress, leads to IVD disease, including back pain and sciatica. The cytokine interleukin (IL)‐17A is elevated in NP cells during IVD disease. Here we explored the pharmacotherapeutic potential of IL‐17A for the treatment of IVD disease using small‐molecule inhibitors that block binding of IL‐17A to the IL‐17A receptor (IL‐17RA). Treatment of NP cells with IL‐17A increased expression of cyclooxygenase‐2 (COX‐2), IL‐6, matrix metalloproteinase (MMP)‐3 and MMP‐13. These increases were suppressed by an IL‐17A‐neutralizing antibody, and small molecules that were identified as inhibitors by binding to the IL‐17A‐binding region of IL‐17RA. IL‐17A signalling also altered sulphated glycosaminoglycan deposition and spheroid colony formation, while treatment with small‐molecule inhibitors of IL‐17A attenuated this response. Furthermore, mitogen‐activated protein kinase pathways were activated by IL‐17A stimulation and induced IL‐6 and COX‐2 expression, while small‐molecule inhibitors of IL‐17A suppressed their expression. Taken together, these results show that IL‐17A is a valid target for IVD disease therapy and that small‐molecule inhibitors that inhibit the IL‐17A–IL‐17RA interaction may be useful for pharmacotherapy of IVD disease.

Osteoarthritis (OA) is a degenerative joint disease characterized by cartilage degradation, subchondral bone remodeling, and joint microenvironment imbalance. Emerging evidence identifies pathological osteoclast–chondrocyte crosstalk as a key OA driver, mediated through RANKL/RANK/OPG, NF‐κB, HIF‐2α, and VEGF signaling pathways that create a destructive bone–cartilage feedback loop. This review examines: (1) molecular mechanisms underlying this cellular communication, (2) therapeutic small‐molecule inhibitors targeting CatK, MMP‐13, NFATc1, and Runx2, and (3) innovative nanomedicine approaches including tissue‐specific nanoparticles, smart delivery systems, and combination therapies. We evaluate these strategies' preclinical validation in animal and organoid models while addressing translational challenges in biosafety, tissue targeting, and personalized delivery. By integrating intercellular signaling knowledge with advanced therapeutic technologies, we provide a framework for developing disease‐modifying OA treatments that bridges basic research with clinical precision medicine applications. Translational roadmap of OA nanotherapeutic platforms toward clinical application.

Cardiac hypertrophy is an important risk factor for heart failure. Epidermal growth factor receptor (EGFR) has been found to play a role in the pathogenesis of various cardiovascular diseases. The aim of this current study was to examine the role of EGFR in angiotensin II (Ang II)‐induced cardiac hypertrophy and identify the underlying molecular mechanisms. In this study, we observed that both Ang II and EGF could increase the phospohorylation of EGFR and protein kinase B (AKT)/extracellular signal‐regulated kinase (ERK), and then induce cell hypertrophy in H9c2 cells. Both pharmacological inhibitors and genetic silencing significantly reduced Ang II‐induced EGFR signalling pathway activation, hypertrophic marker overexpression, and cell hypertrophy. In addition, our results showed that Ang II‐induced EGFR activation is mediated by c‐Src phosphorylation. In vivo, Ang II treatment significantly led to cardiac remodelling including cardiac hypertrophy, disorganization and fibrosis, accompanied by the activation of EGFR signalling pathway in the heart tissues, while all these molecular and pathological alterations were attenuated by the oral administration with EGFR inhibitors. In conclusion, the c‐Src‐dependent EGFR activation may play an important role in Ang II‐induced cardiac hypertrophy, and inhibition of EGFR by specific molecules may be an effective strategy for the treatment of Ang II‐associated cardiac diseases.

Atopic dermatitis (AD) is a complex disease characterized by recurrent eczematous lesions and refractory pruritus that drastically impairs quality of life. Due to the chronic and relapsing course, patients are easily trapped in the debilitating condition. Classical therapies show limitations, especially for patients with moderate‐to‐severe phenotypes. Advanced new insights in targeted therapies exhibit great application prospects which were reinforced by the more profound understanding of the disease pathogenesis. However, the sustained efficiency, biosafety, and long‐term benefits still remain in further exploration. This review summarizes recent clinical studies on oral small‐molecule inhibitors and biological agents for pediatric AD patients, which provides the latest frontiers to clinicians.