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Kaur M, Kaur M, Bandopadhyay T, Sharma A, Priya A, Singh A, Banerjee B. Naturally occurring, natural product inspired and synthetic heterocyclic anti-cancer drugs. PHYSICAL SCIENCES REVIEWS 2022. [DOI: 10.1515/psr-2022-0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Abstract
This chapter describes the importance and activity of a huge number of commercially available naturally occurring, natural product derived or synthetic heterocyclic anti-cancer drugs.
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Affiliation(s)
- Manmeet Kaur
- Department of Chemistry , Akal University , Talwandi Sabo , Bathinda , Punjab 151302 , India
| | - Mandeep Kaur
- Department of Chemistry , Akal University , Talwandi Sabo , Bathinda , Punjab 151302 , India
| | - Tania Bandopadhyay
- Completed MBBS from North Bengal Medical College and Hospital , Darjeeling , West Bengal , Pin-734432 , India
| | - Aditi Sharma
- Department of Chemistry , Akal University , Talwandi Sabo , Bathinda , Punjab 151302 , India
| | - Anu Priya
- Department of Chemistry , Akal University , Talwandi Sabo , Bathinda , Punjab 151302 , India
| | - Arvind Singh
- Department of Chemistry , Akal University , Talwandi Sabo , Bathinda , Punjab 151302 , India
| | - Bubun Banerjee
- Department of Chemistry , Akal University , Talwandi Sabo , Bathinda , Punjab 151302 , India
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Jezeršek Novaković B, Boltežar L, Novaković A. Current Opinion on Pixantrone in the Treatment of Non-Hodgkin B-Cell Lymphoma. Ther Clin Risk Manag 2021; 17:183-192. [PMID: 33688197 PMCID: PMC7936695 DOI: 10.2147/tcrm.s269324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/16/2021] [Indexed: 11/26/2022] Open
Abstract
Not many treatment options exist for patients with relapsed or refractory (R/R) B-cell non-Hodgkin lymphoma (NHL) in whom first- and second-line therapies were unsuccessful. This is especially true for patients with aggressive lymphomas. The innovative agent pixantrone has shown some promising results in terms of disease-free and overall survival, both in monotherapy as well as in combinations. However, recent trials (Phase III and real-world studies) reported unsatisfactory results, thereby raising the question about the role of pixantrone in the current treatment of R/R aggressive lymphomas. Nonetheless, there might still be a potential position for this drug in combinations, for use as first-line treatment of patients with cardiac dysfunction. This article summarizes the definition, structure, mechanism of action and reduced cardiotoxicity of pixantrone as well as efficacy and toxicity both in monotherapy and in combinations, as treatment for aggressive and indolent non-Hodgkin lymphomas.
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Affiliation(s)
| | - Lučka Boltežar
- Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, 1000, Slovenia
| | - Aleksander Novaković
- Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, 1000, Slovenia
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Barrenetxea Lekue C, Grasso Cicala S, Leppä S, Stauffer Larsen T, Herráez Rodríguez S, Alonso Caballero C, Jørgensen JM, Toldbod H, Leal Martínez I, D'Amore F. Pixantrone beyond monotherapy: a review. Ann Hematol 2019; 98:2025-2033. [PMID: 31312929 PMCID: PMC6700039 DOI: 10.1007/s00277-019-03749-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/20/2019] [Indexed: 01/12/2023]
Abstract
Outcomes for patients with non-Hodgkin's lymphoma (NHL) that proves refractory to treatment remain poor. Treatment of such patients is individualized and can include enrolment in a clinical trial of novel agents or use of one of a wide array of drug regimens. Initial treatment with anthracyclines such as doxorubicin limits options at later stages of treatment because of anthracycline-related cumulative cardiotoxicity. The aza-anthracenedione pixantrone was developed to reduce the likelihood of cardiotoxicity without compromising efficacy and is currently conditionally approved for use as monotherapy in patients with multiply-relapsed or refractory aggressive B cell NHL. The use of pixantrone in combination therapy, often to replace doxorubicin or mitoxantrone, has or is currently being investigated in numerous studies in patients with aggressive or indolent NHL and is the focus of this review. These include the R-CPOP regimen (rituximab, cyclophosphamide, pixantrone, vincristine, prednisone) for aggressive NHL in the first-line setting, including a study in elderly patients with limited cardiac function, and for patients with relapsed NHL with prior anthracycline exposure; the PSHAP regimen (pixantrone, cytarabine, prednisone, cisplatin), also in the latter setting; the PREBen/PEBen regimen (pixantrone, bendamustine and etoposide with or without rituximab) as salvage therapy; and pixantrone in combination with fludarabine, dexamethasone, and rituximab (FPD-R) for relapsed indolent NHL.
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Affiliation(s)
| | | | - Sirpa Leppä
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Centre and University of Helsinki, Helsinki, Finland
| | | | | | - Clara Alonso Caballero
- Hospital Universitario Basurto, Avenida de Montevideo, 18, 48013, Bilbao, Vizcaya, Spain
| | - Judit M Jørgensen
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Helle Toldbod
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Irene Leal Martínez
- Hospital Universitario Basurto, Avenida de Montevideo, 18, 48013, Bilbao, Vizcaya, Spain
| | - Francesco D'Amore
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
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Minotti G, Han H, Cattan V, Egorov A, Bertoni F. Pixantrone: novel mode of action and clinical readouts. Expert Rev Hematol 2018; 11:587-596. [DOI: 10.1080/17474086.2018.1476848] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Giorgio Minotti
- Department of Medicine and Unit for Drug Sciences, University Campus Bio-Medico, Rome, Italy
| | - Haiyong Han
- Molecular Medicine Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Valérie Cattan
- R&D Oncology, Institut de Recherches Internationales Servier, Suresnes, France
| | - Anton Egorov
- R&D Oncology, Institut de Recherches Internationales Servier, Suresnes, France
| | - Francesco Bertoni
- Istituto Oncologico di Ricerca, Università della Svizzera italiana, Bellinzona, Switzerland
- Lymphoma Unit, IOSI Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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Therasse P, Perron B, Novack SA, Abastado JP. The Servier oncology pipeline in 2017. Future Oncol 2017; 13:1527-1536. [DOI: 10.2217/fon-2017-0129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Cancer is a complex, multifactorial disease that for years has been the focus of intensive research efforts to explore both the molecular and biological mechanisms involved and the development of novel agents to target these pathways. Servier is an independent French pharmaceutical company with a focus on oncology. Currently, Servier's commercial portfolio includes agents used to treat non-Hodgkin's lymphoma and metastatic colorectal cancer; Servier's oncology pipeline involves agents for the treatment of both solid and hematological tumors. The main areas of future research focus on the development of therapeutics targeting apoptosis or the active immune components involved in tumour development/maintenance. Servier intends to continue its focus on cutting-edge oncology innovation by collaborating with both industry and academia, and maintaining its strong patient-centered approach.
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Affiliation(s)
- Patrick Therasse
- Center for therapeutic innovation, Oncology Servier, Suresnes, France
| | - Beatrice Perron
- Center for therapeutic innovation, Oncology Servier, Suresnes, France
| | - Sarah A Novack
- Global Medical Affairs Oncology, Servier, Suresnes, France
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Malaspina F, Pellegrini C, Casadei B, Argnani L, Zinzani PL. Impressive Response to Pixantrone after Allogeneic Transplant in a Multiple Relapsed Diffuse Large B-Cell Lymphoma. Acta Haematol 2017; 137:191-194. [PMID: 28427046 DOI: 10.1159/000465511] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 02/26/2017] [Indexed: 01/11/2023]
Abstract
Diffuse large B-cell lymphoma is the most frequent histology at diagnosis among non-Hodgkin B lymphomas and can be cured in 50-70% of cases after the first-line chemotherapy regimen. Patients who do not respond to first-line treatment can undergo numerous subsequent steps, culminating in allogeneic stem cell transplant (alloSCT). A relapse after alloSCT, however, carries an awful prognosis, seeing the demise of the patient usually in the following months. Here we present the case of a multiple relapsed patient who successfully underwent therapy with pixantrone after alloSCT, obtaining a complete remission without any considerable side effects.
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Affiliation(s)
- Francesco Malaspina
- Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy
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Pixantrone in relapsed or refractory aggressive non-Hodgkin’s lymphoma: a guide to its use. DRUGS & THERAPY PERSPECTIVES 2017. [DOI: 10.1007/s40267-017-0391-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Keating GM. Pixantrone: A Review in Relapsed or Refractory Aggressive Non-Hodgkin's Lymphoma. Drugs 2017; 76:1579-1586. [PMID: 27757832 DOI: 10.1007/s40265-016-0650-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pixantrone (Pixuvri®) is an aza-anthracenedione with a novel mode of action that is conditionally approved in the EU for use as monotherapy in adult patients with multiply relapsed or refractory aggressive B-cell non-Hodgkin's lymphoma (NHL). In the randomized, open-label, multinational, phase 3 PIX301 trial in patients with multiply relapsed or refractory aggressive NHL, the complete response (CR) plus unconfirmed CR (uCR) rate at the end of treatment (primary endpoint) was significantly higher with intravenous pixantrone monotherapy than with a single-agent comparator (vinorelbine, oxaliplatin, ifosfamide, etoposide, mitoxantrone or gemcitabine). Post hoc analysis also demonstrated a significantly higher CR/uCR rate in the subgroup of patients with centrally confirmed aggressive B-cell NHL who were receiving pixantrone versus a comparator agent as third- or fourth-line therapy. Pixantrone was generally well tolerated in PIX301, with a manageable adverse event profile. In conclusion, pixantrone is a useful option in patients with multiply relapsed or refractory aggressive B-cell NHL. Further results examining the use of pixantrone in combination with rituximab in patients previously treated with rituximab-containing regimens are awaited with interest.
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Affiliation(s)
- Gillian M Keating
- Springer, Private Bag 65901, Mairangi Bay, 0754, Auckland, New Zealand.
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Hong L, Ahles S, Strauss MA, Logemann C, Wegner HA. Synthesis of 2,3-diaza-anthraquinones via the bidentate Lewis acid catalysed inverse electron-demand Diels–Alder (IEDDA) reaction. Org Chem Front 2017. [DOI: 10.1039/c7qo00172j] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A new synthesis of aza-anthraquinones and substituted anthraquinones via bidentate Lewis acid catalysis has been developed.
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Affiliation(s)
- Longcheng Hong
- Institute of Organic Chemistry
- Justus Liebig University Giessen Heinrich-Buff-Ring 17
- 35392 Giessen
- Germany
| | - Sebastian Ahles
- Institute of Organic Chemistry
- Justus Liebig University Giessen Heinrich-Buff-Ring 17
- 35392 Giessen
- Germany
| | - Marcel A. Strauss
- Institute of Organic Chemistry
- Justus Liebig University Giessen Heinrich-Buff-Ring 17
- 35392 Giessen
- Germany
| | - Christian Logemann
- Institute of Inorganic and Analytical Chemistry
- Justus Liebig University Giessen Heinrich-Buff-Ring 17
- 35392 Giessen
- Germany
| | - Hermann A. Wegner
- Institute of Organic Chemistry
- Justus Liebig University Giessen Heinrich-Buff-Ring 17
- 35392 Giessen
- Germany
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Zinzani PL, Corradini P, Martelli M, Minotti G, Oliva S, Spina M, Barosi G, Tura S. Critical concepts, practice recommendations, and research perspectives of pixantrone therapy in non-Hodgkin lymphoma: a SIE, SIES, and GITMO consensus paper. Eur J Haematol 2016; 97:554-561. [PMID: 27124765 DOI: 10.1111/ejh.12768] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES In this paper, we present a review of critical concepts and research perspectives and produce recommendations on the optimal use of pixantrone in non-Hodgkin lymphoma (NHL) by group discussion from an expert panel appointed by the Italian Society of Hematology and the affiliate societies, Società Italiana di Ematologia Sperimentale and Gruppo Italiano Trapianto di Midollo Osseo. METHODS Recommendations were produced using the Delphi process. Scientific evidence on pixantrone efficacy was analyzed using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology in the areas where at least one randomized trial was published. The following key issues were addressed for practical recommendations: pixantrone monotherapy in aggressive relapsed or refractory non-Hodgkin B-cell lymphomas and toxicity risk management in patients candidates to pixantrone. RESULTS AND CONCLUSIONS After a balanced and value-oriented discussion, the panel agreed that the benefit/risk profile was in favor of pixantrone in the treatment of adult patients with multiply relapsed or refractory aggressive NHL B-cell lymphomas. Pixantrone was deemed to be contraindicated in patients with uncontrolled cardiovascular disease. Despite a low rate of cardiotoxicity of pixantrone reported in clinical trials, the panel recommended that all patients receiving pixantrone should undergo periodical cardiac monitoring.
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Affiliation(s)
- Pier Luigi Zinzani
- Institute of Hematology "Seràgnoli", University of Bologna, Bologna, Italy
| | - Paolo Corradini
- Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milano, Milan, Italy
| | - Maurizio Martelli
- Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy
| | - Giorgio Minotti
- Department of Medicine and Units of Drug Sciences and Clinical Pharmacology, University Campus Bio-Medico, Rome, Italy
| | - Stefano Oliva
- Cardiology Unit, National Cancer Institute IRCCS "Giovanni Paolo II", Bari, Italy
| | - Michele Spina
- Division of Medical Oncology A, National Cancer Institute, Aviano, Italy
| | - Giovanni Barosi
- Center of the Study of Myelofibrosis, Biotechnology Research Area, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
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Hasinoff BB, Wu X, Patel D, Kanagasabai R, Karmahapatra S, Yalowich JC. Mechanisms of Action and Reduced Cardiotoxicity of Pixantrone; a Topoisomerase II Targeting Agent with Cellular Selectivity for the Topoisomerase IIα Isoform. J Pharmacol Exp Ther 2015; 356:397-409. [PMID: 26660439 DOI: 10.1124/jpet.115.228650] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 12/09/2015] [Indexed: 01/09/2023] Open
Abstract
Pixantrone is a new noncardiotoxic aza-anthracenedione anticancer drug structurally related to anthracyclines and anthracenediones, such as doxorubicin and mitoxantrone. Pixantrone is approved in the European Union for the treatment of relapsed or refractory aggressive B cell non-Hodgkin lymphoma. This study was undertaken to investigate both the mechanism(s) of its anticancer activity and its relative lack of cardiotoxicity. Pixantrone targeted DNA topoisomerase IIα as evidenced by its ability to inhibit kinetoplast DNA decatenation; to produce linear double-strand DNA in a pBR322 DNA cleavage assay; to produce DNA double-strand breaks in a cellular phospho-histone γH2AX assay; to form covalent topoisomerase II-DNA complexes in a cellular immunodetection of complex of enzyme-to-DNA assay; and to display cross-resistance in etoposide-resistant K562 cells. Pixantrone produced semiquinone free radicals in an enzymatic reducing system, although not in a cellular system, most likely due to low cellular uptake. Pixantrone was 10- to 12-fold less damaging to neonatal rat myocytes than doxorubicin or mitoxantrone, as measured by lactate dehydrogenase release. Three factors potentially contribute to the reduced cardiotoxicity of pixantrone. First, its lack of binding to iron(III) makes it unable to induce iron-based oxidative stress. Second, its low cellular uptake may limit its ability to produce semiquinone free radicals and redox cycle. Finally, because the β isoform of topoisomerase II predominates in postmitotic cardiomyocytes, and pixantrone is demonstrated in this study to be selective for topoisomerase IIα in stabilizing enzyme-DNA covalent complexes, the attenuated cardiotoxicity of this agent may also be due to its selectivity for targeting topoisomerase IIα over topoisomerase IIβ.
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Affiliation(s)
- Brian B Hasinoff
- College of Pharmacy, Apotex Centre, University of Manitoba, Winnipeg, Manitoba, Canada (B.B.H., X.W., D.P.); and Division of Pharmacology, College of Pharmacy, Ohio State University, Columbus, Ohio (R.K., S.K., J.C.Y.)
| | - Xing Wu
- College of Pharmacy, Apotex Centre, University of Manitoba, Winnipeg, Manitoba, Canada (B.B.H., X.W., D.P.); and Division of Pharmacology, College of Pharmacy, Ohio State University, Columbus, Ohio (R.K., S.K., J.C.Y.)
| | - Daywin Patel
- College of Pharmacy, Apotex Centre, University of Manitoba, Winnipeg, Manitoba, Canada (B.B.H., X.W., D.P.); and Division of Pharmacology, College of Pharmacy, Ohio State University, Columbus, Ohio (R.K., S.K., J.C.Y.)
| | - Ragu Kanagasabai
- College of Pharmacy, Apotex Centre, University of Manitoba, Winnipeg, Manitoba, Canada (B.B.H., X.W., D.P.); and Division of Pharmacology, College of Pharmacy, Ohio State University, Columbus, Ohio (R.K., S.K., J.C.Y.)
| | - Soumendrakrishna Karmahapatra
- College of Pharmacy, Apotex Centre, University of Manitoba, Winnipeg, Manitoba, Canada (B.B.H., X.W., D.P.); and Division of Pharmacology, College of Pharmacy, Ohio State University, Columbus, Ohio (R.K., S.K., J.C.Y.)
| | - Jack C Yalowich
- College of Pharmacy, Apotex Centre, University of Manitoba, Winnipeg, Manitoba, Canada (B.B.H., X.W., D.P.); and Division of Pharmacology, College of Pharmacy, Ohio State University, Columbus, Ohio (R.K., S.K., J.C.Y.)
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