The camptothecins

Supported by detailed understanding of their mechanism of action, and facilitated by chemical manipulations that have amplified their solubility, the camptothecins have advanced to the forefront of several areas of therapeutic and developmental chemotherapy. Additive and synergistic laboratory inter...

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Bibliographic Details
Published in:The Lancet (British edition) 2003-06, Vol.361 (9376), p.2235-2242
Main Authors: Pizzolato, Joseph F, Saltz, Leonard B
Format: Article
Language:English
Subjects:
Animals
Antineoplastic agents
Antineoplastic Agents, Phytogenic - adverse effects
Antineoplastic Agents, Phytogenic - chemistry
Antineoplastic Agents, Phytogenic - pharmacokinetics
Antineoplastic Agents, Phytogenic - therapeutic use
Biological and medical sciences
Bone Marrow - drug effects
Camptothecin - adverse effects
Camptothecin - analogs & derivatives
Camptothecin - chemistry
Camptothecin - pharmacokinetics
Camptothecin - therapeutic use
Cancer
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Small Cell - drug therapy
Chemotherapy
Diarrhea - chemically induced
Drug therapy
Female
Gastrointestinal Neoplasms - drug therapy
Humans
Lung cancer
Lung Neoplasms - drug therapy
Medical sciences
Ovarian Neoplasms - drug therapy
Pharmacology
Pharmacology. Drug treatments
Structure-Activity Relationship
Topoisomerase I Inhibitors
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Summary:Supported by detailed understanding of their mechanism of action, and facilitated by chemical manipulations that have amplified their solubility, the camptothecins have advanced to the forefront of several areas of therapeutic and developmental chemotherapy. Additive and synergistic laboratory interactions with other cytotoxic drugs have been exploited to allow development of camptothecin-based multidrug regimens, which are showing important activity in several malignancies. Topotecan and irinotecan are already in widespread use in clinical practice, and newer agents with promising preclinical activity are in various stages of clinical assessment. As knowledge of molecular and biochemical mechanisms of action and resistance continues to expand, newer and better camptothecin-based strategies for treatment of malignant disease are likely to evolve.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(03)13780-4