Single agents against multiple drug targets are highly topical. Hormonedependent breast cancer (HDBC) may be more effectively treated by dual inhibition of aromatase and steroid sulfatase (STS), and several dual aromatase-sulfatase inhibitors (DASIs) have been recently reported. The best compounds from two leading classes of DASI, 3 and 9, are low nanomolar inhibitors. In search of a novel class of DASI, core motifs of two leading classes were combined to give a series of hybrid structures, with several compounds showing markedly improved dual inhibitory activities in the picomolar range in JEG-3 cells. Thus, DASIs 14 (IC 50 : aromatase, 15 pM; STS, 830 pM) and 15 (IC 50 : aromatase, 18 pM; STS, 130 pM) are the first examples of an exceptional new class of highly potent dual inhibitor that should encourage further development toward multitargeted therapeutic intervention in HDBC.KEYWORDS: Hybrid, dual inhibitors, aromatase, sulfatase, cancer E strogen deprivation has been an effective therapeutic intervention for hormone-dependent breast cancer (HDBC). One established and clinically proven approach involves the inhibition of the aromatase enzyme, 1-3 although the inhibition of steroid sulfatase (STS) is an emerging new strategy, as demonstrated by promising results for STX64 (Irosustat, BN83495), [4][5][6] the first STS inhibitor that entered clinical trials. Since both aromatase and STS are targets for treating HDBC, it has been reasoned that estrogen deprivation may be more comprehensively achieved by dual inhibition of both enzymes.Designing single agents that act against multiple biological targets is of increasing interest and prominence. In recent years, an increasing volume of work has been published exemplifying the successful use of this strategy. [7][8][9][10][11][12][13][14][15][16][17] We have pioneered this approach to augment our strategy directed at the first-in-class clinical target of STS inhibition and successfully developed three series of single agent dual aromatase and sulfatase inhibitors (DASIs) that are sulfamate derivatives of the nonsteroidal aromatase inhibitor (AI) 4-((4-bromobenzyl)-[1,2,4]-triazol-4-ylamino)benzonitrile (1) (e.g., 2 and 3), 18-20 letrozole 4 (e.g., 5), 21,22 and anastrozole 6 (e.g., 7) (Figure 1). 23 The design of these DASIs shares a common principle of engendering the irreversible STS inhibitory pharmacophore (ie. an aryl sulfamate ester, ArOSO 2 NH 2 ) into a clinical or experimental AI with minimal structural change incurred on the original scaffold in order to retain and maximize aromatase inhibition. More recently, a different design approach was employed. A series of biphenyl-based DASIs was developed as a result of incorporating the reversible aromatase inhibitory pharmacophore, which is principally a heme-ligating nitrogen-containing heterocycle, into a known sulfamate-based STS inhibitor (e.g., 8 and 9, Figure 1). 24 On evaluating the lead candidates from these four structural classes of DASI, all of them showed in vitro and in vivo dual inhibito...