Key words: anthracycline; topoisomerase II; nuclear factor-B; p53; apoptosis MEN 10755 is a new disaccharide anthracycline, currently undergoing phase II clinical evaluation, which showed, in preclinical studies, improved antineoplastic activity and reduced cardiotoxicity compared to the parent compound, DXR. [1][2][3] The mechanism of action of anthracyclines is primarily based on their ability to "poison" topo II enzymes, which are critical for cell survival; they play an important role in DNA replication, regulating the topologic state of DNA, and are involved in the condensation and segregation of chromosomes. Topo II enzymatic activity involves induction of DNA breaks and their subsequent resealing. Anthracyclines stabilize the enzyme in a covalent complex, known as the ternary complex, in which DNA, the enzyme and drug are locked. Resealing of DNA breaks is then prevented, leading to generation of lethal DNA damage. 4 It is well known that DNA damage results in activation of the transcription factor p53, 5-7 and the subsequent sequence-specific binding of p53 to DNA induces expression of genes mediating both cell-cycle arrest (i.e., p21 WAF1/CIP1 ) 8,9 and DNA repair (i.e., GADD45) 10 and suppression of antiapoptotic genes, e.g., those belonging to the IAP family. 11 The overall result of this pattern of gene regulation is the induction of cell death.On the contrary, induction of the transcription factor NF-B in response to antineoplastic agents has been revealed only recently. Data in the literature indicate that NF-B can be activated, other than by a wide array of biologic stimuli, by DNA double-strand breaks induced by chemotherapeutic drugs. 12,13 NF-B is a dimeric complex of proteins of the Rel family, which includes 5 members identified so far: NF-B1 (p50/p105), NF-B2 (p52/ p100), c-Rel, RelB and p65 (RelA); in most cell types, heterodimers of p50 and p65 are primarily found. NF-B complexes are mainly maintained inactive in the cytoplasm, bound to a protein of the IB family that masks their nuclear localization signal. 14 Complete functional activation of NF-B is achieved by phosphorylation-dependent degradation of the inhibitory IB subunit, allowing the transcription factor to translocate to the nucleus, 15 and by p65 subunit phosphorylation. 16,17 Clear evidence supports a role of NF-B in mediating an antiapoptotic response to genotoxic agents and in the induction of resistance to different chemotherapeutic drugs, 18 -22 through activation of specific target genes. Nevertheless, much debate is arising on the role of NF-B as a chemosensitizing agent; indeed, reports suggest that inhibiting NF-B-driven gene activation may be irrelevant or even detrimental to successful anticancer therapy. 23,24 This picture is further complicated by the complex relationships existing between p53 and NF-B transcription factors, which have been reported to cooperate but also to antagonize each other in gene transactivation. [25][26][27][28][29][30] We used the p53 wild-type human carcinoma cell line A2780 to investigat...