The
discovery that certain indenoisoquinolines inhibit the religation
reaction of DNA in the topoisomerase I-DNA-indenoisoquinoline ternary
complex led to a structure-based drug design research program
which resulted in three representatives that entered Phase I clinical
trials in cancer patients at the National Cancer Institute. This has
stimulated a great deal of interest in the design and execution of
new synthetic pathways for indenoisoquinoline production. More recently,
modulation of the substitution pattern and chemical nature of substituents
on the indenoisoquinoline scaffold has resulted in a widening scope
of additional biological targets, including RXR, PARP-1, MYC promoter
G-quadruplex, topoisomerase II, estrogen receptor, VEGFR-2, HIF-1α,
and tyrosyl DNA phosphodiesterases 1 and 2. Furthermore, convincing
evidence has been advanced supporting the potential use of indenoisoquinolines
for the treatment of diseases other than cancer. The rapidly expanding
indenoisoquinoline knowledge base has provided a firm foundation for
further advancements in indenoisoquinoline chemistry, pharmacology,
and therapeutics.