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[Structure and activity of anthracyclines].

Several mechanisms are proposed for explaining the antitumor activity and the toxicity of anthracyclines. The first recognized biochemical target is DNA. Anthracyclines and DNA lead to the formation of complexes of intercalation. The intercalation can explain biochemical properties such as inhibition of DNA polymerase and of RNA polymerase. On the other hand, the intercalation cannot explain the chromosomal damages observed in cancer cells following in vivo administration or in vitro incubation. Additional mechanisms are proposed such as biological reduction of quinone C ring, leading to the formation of radical species able to react covalently with DNA. More recently, an interaction of anthracyclines with topoisomerase II has been also described. There is no clear correlation between antitumour efficacy and DNA intercalation. However it must be pointed out that no anthracycline has been found so far which shows antitumour activity dissociated from the ability of interacting with DNA. Anthracyclines interact with membranes: interaction with negatively charged phospholipids like cardiolipin; peroxidation of membrane lipids following biological reduction of the quinone C ring. These membrane effects are believed to be responsible for chronic cardiac toxicity. The clinical activity of daunorubicin and of doxorubicin leads to considerable work with the hope to discover more active and/or less toxic congeners. Several possibilities are investigated: isolation of new anthracyclines from natural sources (fermentation broths); chemical modifications of the whole molecule; total synthesis of new sugars and of new aglycones.