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Twelve years ago a group of cholestane glycosides was isolated from the bulbs of Ornithogalum saundersiae, a species of the lily family without any medicinal folklore background. Similar glycosides were recently isolated from Galtonia candicans. The major component of the mixture of saponins, OSW-1, exhibited sub-nanomolar antineoplastic activity. While OSW-1 is exceptionally cytotoxic against various tumor cells, it shows little toxicity with normal human pulmonary cells. In this review article the synthetic efforts towards OSW-1 and related cholestane glycosides, as well as the preliminary results of the structure-activity relationship study are presented.