Metabolic fate of 1-hexylcarbamoyl-5-fluorouracil after oral administration in mice

Versatile use of Carmofur: A comprehensive review of its chemistry and pharmacology

Carmofur, 1-hexylcarbamoyl-5-fluorouracil (HCFU) is an antineoplastic drug, which has been in clinics in Japan since 1981 for the treatment of colorectal cancer. Subsequently, it was also introduced in China, Korea, and Finland. Besides colorectal cancer, it has also shown antitumor activity in other cancers such as breast, head and neck, pancreatic, gastrointestinal, and solid brain tumors. A prodrug of 5-fluorouracil (5-FU), carmofur has shown better gastrointestinal stability and superior antiproliferative activity compared to its active counterpart 5-FU. Recently, carmofur has gained attention as an acid ceramidase inhibitor and as a potential lead compound against several noncancerous diseases such as coronavirus disease 2019, Krabbe disease, acute lung injury, Parkinson's disease, dementia, childhood ependymoma etc. Carmofur has also been reported to have antifungal, and antimicrobial properties. Nevertheless, no comprehensive review is available on this drug. Herein, we summarized the chemistry, pharmacokinetics, and pharmacology of carmofur based on the literature published between January 1976 and March 2022 as identified from PubMed and Google Scholar search engines.

Discovery of highly potent acid ceramidase inhibitors with in vitro tumor chemosensitizing activity

The expression of acid ceramidase (AC) - a cysteine amidase that hydrolyses the proapoptotic lipid ceramide - is abnormally high in several human tumors, which is suggestive of a role in chemoresistance. Available AC inhibitors lack, however, the potency and drug-likeness necessary to test this idea. Here we show that the antineoplastic drug carmofur, which is used in the clinic to treat colorectal cancers, is a potent AC inhibitor and that this property is essential to its anti-proliferative effects. Modifications in the chemical scaffold of carmofur yield new AC inhibitors that act synergistically with standard antitumoral drugs to prevent cancer cell proliferation. These findings identify AC as an unexpected target for carmofur, and suggest that this molecule can be used as starting point for the design of novel chemosensitizing agents.

Effect of (E)-5-(2-bromovinyl)-2'-deoxyuridine on life-span and 5-fluorouracil metabolism in mice with hepatic metastases

5-Fluorouracil (5FU) is rapidly metabolised in the liver by dihydrouracil dehydrogenase. Bromovinyluracil is formed in the liver from (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) by pyrimidine nucleoside phosphorylase and is a potent inhibitor of dihydrouracil dehydrogenase. The co-administration of 5FU (intravenously) and BVDU (orally) was investigated in normal BDF1 mice and in those bearing liver metastases of Lewis lung carcinoma. 5FU alone rapidly disappeared from plasma and liver within 60 min of dosing. Administered with BVDU, 5FU persisted in plasma and liver for 60-180 min. The combination also significantly enhanced the life-span of tumour-bearing mice. 5FU plus BVDU may have therapeutic potential in the treatment of primary and secondary liver tumours.

Potentiation of the chemotherapeutic action of tegafur against solid adenocarcinoma 755 by combination with L-cystine

The chemotherapeutic action of tegafur (FT) against adenocarcinoma 755 in mice was markedly potentiated by oral administration of L-cysteine and L-cystine without increasing its toxicity. In particular, the combination of FT at 200 mg/kg per day (maximum dose) and 1000 mg/kg per day of L-cystine markedly inhibited tumor growth. The dose ratio of L-cysteine or L-cystine to FT needs 5 by weight to potentiate the antitumor activity of FT. The antitumor activity of 5-fluorouracil (FU) was slightly, but not significantly, increased by L-cysteine. The total concentration of FT in the plasma and the tumor when it was given in combination with L-cystine was significantly increased when compared with FT alone 1 h after oral administration. The FU level in the plasma after administration of the combination of FT and L-cystine was three times higher than that after FT alone, and the FU level in the tumor after treatment with the combination of FT and L-cystine was also higher (about 20%) than that after FT alone. This significant increase in FT and FU levels in the plasma and the tumor may be related to the potentiation of the antitumor activity of FT by L-cystine.