Increased FOXO3 nuclear localization is involved in neuroblastoma chemoresistance and tumor angiogenesis. Accordingly, FOXO3 inhibition is a promising strategy for boosting antitumor immune responses and suppressing FOXO3-mediated therapy resistance in cancer cells. However, no FOXO3 inhibitors are currently available for clinical use. Nevertheless, we have recently identified (4-propoxy)phenylpyrimidinylguanidine as a FOXO3 inhibitor in cancer cells in the low micromolar range. Here, we report the synthesis and structure−activity relationship study of a small library of its derivatives, some of which inhibit FOXO3-induced gene transcription in cancer cells in a submicromolar range and are thus 1 order of magnitude more potent than their parent compound. By NMR and molecular docking, we showed that these compounds differ in their interactions with the DNA-binding domain of FOXO3. These results may provide a foundation for further optimizing (4-propoxy)phenylpyrimidinylguanidine and developing therapeutics for inhibiting the activity of forkhead box (FOX) transcription factors and their interactions with other binding partners. ■ INTRODUCTION Forkhead box (FOX) transcription factors display high functional diversity and participate in development, proliferation , differentiation, stress resistance, apoptosis, and metabolic control processes. 1 This diverse group of transcriptional regulators shares a conserved, 110-amino-acid-long, DNA-binding domain (DBD) known as the Forkhead domain. 2,3 The O subclass of FOX transcription factors consists of four members, namely, FOXO1, FOXO3, FOXO4, and FOXO6, which are key regulators of cellular homeostasis, longevity, and stress responses. 4−7 All FOXO proteins recognize the consensus DNA sequence 5′-TTGTTTAC-3′, and their transcriptional activity is negatively regulated by the proproliferative phosphoinositide 3-kinase (PI3K)/protein kinase B (PKB, also known as Akt) signaling pathway. 5,8 PKB/Akt phosphorylates three Ser/Thr residues and induces the nuclear exclusion of FOXO proteins in a process involving binding to the scaffolding 14-3-3 protein. 9−11 In addition to phosphorylation by PKB/Akt, FOXO proteins are further regulated through phosphorylation by other kinases, acetylation, ubiquitination, and methyl-ation. 12 Phosphorylation by stress-induced signaling kinases, such as JNK and MST1, can override the effect of the PKB/ Akt-mediated phosphorylation of FOXO3 and induce its nuclear localization and activation, thus promoting FOXO3-triggered therapy resistance in cancer cells. 13−15 In cancer, FOXO3 stands out for its dual role. On the one hand, FOXO3 induces cell cycle arrest and apoptosis, thus functioning as a typical tumor suppressor. 16 On the other hand, FOXO3 activity can also promote tumor development and progression by inducing drug resistance, 7,17 cyclin transcription upregulation, 18 cellular detoxification, 19,20 and cancer stem cell maintenance 13 and by inhibiting apoptosis inducers such as the transcription factor p53. 14 Moreover, all FOXO proteins also regulate T cell differentiation, especially the pathway that leads to the development and function of regulatory T cells. 21,22 Therefore, pharmacological inhibition of FOXO3 transcriptional activity is considered a highly promising approach to boosting antitumor immune responses and suppressing FOXO3-mediated therapy resistance in cancer cells.