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HO NH2 Idarubicin

Pirarubicin, a 4'-tetrahydropyranyl doxorubicin,42 and aclarubicin (aclacino-mycin A), a trisaccharide anthracycline,43 showed only modest improvements over DOX and DNR in terms of drug resistance without relevant cardiotoxic safety. Zorubicin, the daunorubicin benzoylhydrazone,44 and valrubicin,45 have also been marketed. The latter compound is indicated for in situ intravesical therapy46 of BCG-refractory carcinomas of the urinary bladder.47

Among other analogs that have reached clinical trials we can mention nogala-mycin that was first isolated in 1968 and lately modified to give menogaril (TUT-7).48 In this compound, the daunosamine is replaced by a methoxy group and other amino-sugar is attached to the D-ring through a glycosidic linkage and a C-C- bond. Menogaril is active against several human lymphomas and has been advanced to Phase II clinical trials in patients with previously treated multiple myeloma or chronic lymphocytic leukemia.49

Another interesting compound is nemorubicin (MMRA), a DOX analog bearing 2(S)-methoxy-4-morpholinyl, for which faster cell extravascular diffusion and cell uptake and lower cardiotoxic effects were claimed,50 and which is in Phase III clinical studies.

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