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Analogues of daunorubicin possessing a fluorine atom at position C(8) of ring A have been synthesized with the aim of comparing their DNA-drug interaction and antitumour properties with those of the clinically useful anthracyclines doxorubicin and idarubicin. The synthesis of (8S)-8-fluoro-4-demethoxydaunorubicin, 1, is reported and molecular mechanics and NMR studies which guided towards the synthesis of the epimeric (8R)-8-fluoro-4-demethoxydaunorubicin, 2, are discussed. Both compounds were prepared by divergent routes starting from the common intermediate, 6, obtained via the Diels-Alder cyclisation between quinizarin diquinone, 3, and 2-(l-hydroxyethyl)-l,3-butadiene, 4. The synthesis of the (8S)-fluoroepimer proceeded via epoxidation of the C(8)-C(9) olefinic bond of 6, oxidation, oxirane cleavage by BF3 • Et20 to give the fluorohydroxyketone, 9, followed by the introduction of the hydroxyl moiety at C(7) and glycosylation. Conversely, the synthesis of the (8R)-fluoroepimer involved the fluorobromination of the C(8)-C(9) olefinic bond of 6, formation of the C(9)-C(13) epoxide, 20 which, after regioselective hydrolysis and oxidation of the resulting fluorodiol to the epimeric fluoro­hydroxyketone, 21, similarly gave the desired fluoroaglycone, 25 and, hence, the corresponding glycoside, 2. The cytotoxic properties of the two 8-fluoroanthracycline analogues, 1 and 2, were markedly affected by the stereochemistry of the fluorine substituent.
Ovarian cancer represents the fifth most frequent cause of death as a result of malignant processes after cancers of the breast, large intestine, lung and stomach. Owing to the localisation of ovarian cancer, approximately 75% of cases are diagnosed at the III and IV stages of advancement according to FIGO. Because of the advanced stage of the disease surgery has to be followed by chemotherapy in most cases of ovarian cancer and therefore resistance to cytostatic drugs represents a major clinical problem. The potential to predict the response to therapy with the use of cytostatic drugs would enable the most effective drugs to be applied in individual cases, thus improving the efficiency of the treatment and restricting the development of resistance to cytostatic drugs. In the present paper the progress made so far in the prediction of the clinical course of ovarian cancer is reviewed. The significance of the expression of the ATP-binding cassette (ABC) transporters is described, including P-glycoprotein and MRP2, the principal representatives of the protein group. The importance of disturbed control of apoptosis and the overexpression of HER-2 and topoisomerase 1A are also discussed. Two sections are devoted to the most recent studies in the biology of ovarian cancer, pangenomic studies on gene expression using DNA microarrays and aberrations of DNA methylation.
Malignant fibrous histiocytoma (MFH) is a morphologically ill-defined tumour of the soft tissues and may involve nearly every organ of the body. MFH of the spermatic cord represents an extremely rare entity and reports of it in the literature are limited. We report a 69-year-old man found to have a left spermatic cord MFH and retroperitoneal and mediastinal lymphadenopathy, who was treated with radical orchiectomy and adjuvant chemotherapy. The morphological findings of the spermatic tumour are presented and the literature is reviewed to clarify the potential diagnostic/therapeutic approaches and the prognosis related to spermatic cord MFH.
Methicillin-resistant Staphylococcus aureus (MRSA) has two mechanisms of resistance to P-lactam antibiotics; one is mediated by mecA gene expression, and the other by penicillinase production. It has been generally accepted in the clinical field that β-lactam antibiotics are not the drugs of choice for MRSA infection. In this report, however, ampicillin and penicillin G were shown to have relatively good activity against MRSA if combined with a β-lactamase inhibitor, sulbactam. These β-lactam antibiotics were found to have relatively high binding affinities to PBP2', the mecA-encoded MRSA-specific penicillin-binding protein. The possible therapeutic application of sulbactam/ampicillin against MRSA infection in combination with arbekacin, an aminoglycoside antibiotic newly developed and introduced into clinical use in Japan, is discussed.
Glufosfamide (β-D-glucosyHfosfamide mustard) is a new agent for cancer chemo­therapy. Its pharmacology is similar to commonly used oxazaphosphorines, but it does not require activation by hepatic cytochrome P-450 and preclinically demon­strates lower nephrotoxicity and myelosuppression than ifosfamide. The aim of the study was a comparison of the drug resistance profiles of glufosfamide and other oxazaphosphorines in childhood acute leukemias. Leukemic cells, taken from chil­dren with ALL on diagnosis (n = 41), ALL on relapse (n = 12) and AML on diagnosis (n = 13) were analyzed by means of the MTT assay. The following drugs were tested: glufosfamide (GLU), 4-HOO-ifosfamide (IFO), 4-HOO-cyclophosphamide (CYC) and mafosfamide cyclohexylamine salt (MAF). In the group of initial ALL samples median cytotoxicity values for GLU, IFO, CYC and MAF were 15.5, 33.8, 15.7 and 7.8,«M, re­spectively. In comparison with initial ALL samples, the relative resistance for GLU and IFO in relapsed ALL samples was 1.9 (p = 0.049) and 1.3 (ns), and in initial AML samples 31 (p < 0.001) and 5 (p = 0.001), respectively. All oxazaphosphorines pre­sented highly significant cross-resistance. Glufosfamide presented high activity against lymphoblasts both on diagnosis and on relapse.
Doxorubicin is co-transported with glutathione by several multidrug resistance proteins (MRPs). In order to check whether weak non-covalent aggregates between doxorubicin and glutathione can be formed, which might be substrates for the transporter, the effect of glutathione on the partition coefficient of doxorubicin was studied. No evidence of an effect of glutathione (at levels up to 20 mM) on the partition coefficient of doxorubicin was found in the pH range of 4.0-7.4. These results indicate that non-covalent doxorubicin-glutathione complexes do not form.
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