Med Oncol. 2026 Jan 20. 43(2):
122
Oral squamous cell carcinoma (OSCC) is a prevalent malignancy with poor prognosis due to therapeutic resistance and tumor heterogeneity. N6-methyladenosine (m6A) modification, mediated by methyltransferase-like 3 (METTL3), drives OSCC progression via the HNRNPA2B1/FOXQ1 axis. STM2457, a selective METTL3 inhibitor, and Astragalus polysaccharide (APS), a traditional Chinese medicine with antitumor properties, hold promise for enhancing OSCC treatment, but their combined efficacy remains unexplored. In CAL27 OSCC cells, optimal concentrations of STM2457 (15 µM) and APS (100 µg/mL) were determined using EdU assays. Effects on m6A levels, METTL3, HNRNPA2B1, and FOXQ1 expression, and mRNA stability were assessed via RT-qPCR, Western blot, and RIP-qPCR. Cell proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) were evaluated using EdU, wound healing, and Transwell assays. In vivo efficacy was tested in nude mouse xenografts treated with STM2457 (50 mg/kg/day) and APS (80 mg/kg/day), with tumor growth and FOXQ1 expression analyzed. Combined STM2457 and APS treatment significantly reduced m6A levels, METTL3, HNRNPA2B1, and FOXQ1 expression, and mRNA stability compared to single-drug treatments, approaching or surpassing METTL3 silencing effects. The combination markedly suppressed cell proliferation, migration, invasion, and EMT, with increased E-cadherin and decreased N-cadherin levels. Regarding the role of APS in regulating m6A, we acknowledge that the current evidence is speculative and requires further mechanistic validation. In vivo, combination therapy significantly reduced tumor growth and FOXQ1 expression, outperforming single-drug treatments. STM2457 and APS enhance the inhibitory effects on OSCC progression by targeting the METTL3/HNRNPA2B1/FOXQ1 axis, offering a potential therapeutic strategy that integrates precision oncology with traditional herbal medicine. Further mechanistic and clinical studies are warranted to validate these findings.
Keywords: Astragalus polysaccharide; M6A; METTL3; Oral squamous cell carcinoma; STM2457