Phase I and II Agents in Cancer Therapy: I. Anthracyclines and Related Compounds

Abstract

Anthracycline antibiotics remain among the most potent anticancer drugs, but their efficacy is limited by the development of a dose-dependent irreversible cardiomyopathy and by the emergence of clones of tumor cells resistant to the effects of the drug. Modifications of the basic anthracycline structure have resulted in molecules that may share the activity of the parent compound, with amelioration of some toxicities, absence of cross-resistance, or activity against tumors insensitive to the parent drug. Epirubicin has a unique metabolic pathway, glucuronidation, that may result in more rapid plasma clearance and reduced toxicity as compared with doxorubicin. Epirubicin has demonstrated comparable activity to doxorubicin in breast cancer, with possibly reduced toxicity. Idarubicin is of interest because of its cytotoxic activity when given orally. Idarubicin has prolonged retention in the plasma and has equal cytotoxic activity to the parent compound. Idarubicin has demonstrated activity against acute leukemia and breast cancer; in the latter tumor category, some doxorubicin-resistant tumors have responded. Esorubicin is of interest because of its nearly absent cardiac toxicity. This agent has some activity against solid tumors and is currently being clinically tested. Aclacinomycin A is an anthracycline in which a trisaccharide is substituted for the aminosugar. Aclacinomycin A and the related compound marcellomycin are of interest as both cytotoxic and differentiating agents. Menogaril is an anthracycline with the aminosugar on the D ring; it does not exhibit cross-resistance with doxorubicin or cardiotoxicity. Mitoxantrone is a compound that is related to the anthracyclines but has a different mechanism of action. This agent has significant activity against acute leukemia and breast cancer and is currently being compared with doxorubicin. Amsacrine is another compound related to the anthracyclines that possesses major activity against acute leukemias. Minor modifications of the anthracycline molecule have had major impact on the biologic activity of these drugs. New anthracycline analogues with up to 100 times the potency of currently available anthracyclines are being developed for clinical testing, and these complex molecules retain a nearly unlimited potential for structural modification.

Haemotoxicity of busulphan, doxorubicin, cisplatin and cyclophosphamide in the female BALB/c mouse using a brief regimen of drug administration

“…DOX is a cytotoxic antibiotic widely used in the treatment of acute leukaemias, lymphomas, Hodgkin's disease and sarcomas and in a range of tumours of the breast, bladder and lung (Bonadonna et al 1969(Bonadonna et al , 1975Benjamin et al 1974;Wadler et al 1986;Johnson and Richardson 1998). The toxic effects of DOX are doserelated.…”

Altered Left Ventricular Diastolic Performance in Oncologic Patients Treated With Epirubicin

“…Cardiotoxicity may be induced by different cytotoxic agents: anthracyclines, 5‐fluorouracil, cyclophosphamide, amsacrine, busulfan, mitomycin, dacarbazine, cisplatin, vincristine, and interferon. Anthracycline antibiotics remain among the most potent anticancer drugs, but their efficacy is limited by the development of dose‐dependent irreversible cardiomyopathy and by the emergence of tumor cell clones resistant to the effects of the drug 9 . Since 1967, different studies have documented the cardiotoxicity of anthracyclines 10,11 .…”

The Gulf Oil Spill

“…It is also used in smoke screens, as scintillation counter crystals, and in organic semiconductor research (Hawley 1987). Anthracene is used to synthesize the chemotherapeutic agent, Amsacrine (Wadler et al 1986). Acenaphthene is used as a dye intermediate, in the manufacture of pharmaceuticals and plastics, and as an insecticide and fungicide (HSDB 1994;Windholz 1983).…”