ABSTRACT
Hypoxia, a state of low oxygen, is a common feature of solid tumors and is associated with disease progression as well as resistance to radiotherapy and certain chemotherapeutic drugs. Hypoxic regions in tumors, therefore, represent attractive targets for cancer therapy. To date, five distinct classes of bioreactive prodrugs have been developed to target hypoxic cells in solid tumors. These hypoxia-activated prodrugs, including nitro compounds, N-oxides, quinones, and metal complexes, generally share a common mechanism of activation whereby they are reduced by intracellular oxidoreductases in an oxygen-sensitive manner to form cytotoxins. Several examples including PR-104, TH-302, and EO9 are currently undergoing phase II and phase III clinical evaluation. In this review, we discuss the nature of tumor hypoxia as a therapeutic target, focusing on the development of bioreductive prodrugs. We also describe the current knowledge of how each prodrug class is activated and detail the clinical progress of leading examples.
Subject(s)
Humans , Anthraquinones , Chemistry , Pharmacology , Antineoplastic Agents , Chemistry , Pharmacology , Aziridines , Chemistry , Pharmacology , Cell Hypoxia , Indolequinones , Chemistry , Pharmacology , Molecular Structure , NAD(P)H Dehydrogenase (Quinone) , Chemistry , Pharmacology , Neoplasms , Drug Therapy , Pathology , Nitrogen Mustard Compounds , Chemistry , Pharmacology , Nitroimidazoles , Chemistry , Pharmacology , Phosphoramide Mustards , Chemistry , Pharmacology , Prodrugs , Chemistry , Pharmacology , Triazines , Chemistry , PharmacologyABSTRACT
Owing to stratospheric ozone depletion (SOD) the natural flux of ultraviolet B (UVB) radiation (290-320 nm) is likely to increase on the earth surface. In our efforts to identify endogenous chromophores which may absorb significantly in the UVB range and subsequently induce phototoxic reactions, we have observed that tryptophan (Trp) was quite photoreactive under UVB. It enhanced considerably the oxygen-dependent photooxidation of tyrosine (Tyr) to dopachrome, a precursor of melanin. Our data suggest that UVB-sensitized Trp produces singlet oxygen (1O2) and superoxide radicals (O2-.), and these reactive forms of oxygen may contribute to membrane-, cytoplasm- and DNA-damaging effects. In the event of an increasing SOD level, other UVB chromophores may also exhibit similar phototoxic properties to lead to a definitive imbalance between cell life, injury and death.