“…30 derivatives, amonafide (11, AS1413) and mitonafide (14, NSC 300288), have been studied in phase III and phase II clinical trials, respectively. 31,32 Resistance to chemotherapeutic drugs has been a major obstacle in cancer chemotherapy. Most topo II poisons have frequently suffered from MDR, which is related to the overexpression of MDR-associated proteins (i.e., P-gp, MDR1, MRP1, and BCRP), resulting in enhanced efflux of chemotherapeutic drugs out of the cells.…”