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Purine nucleoside antimetabolites in development for the treatment of cancer.

Purine nucleoside analogs are an important class of drugs that are used in the treatment of cancer. Five purine analogs have been approved by the FDA (mercaptopurine, thioguanine, fludarabine monophosphate, deoxycoformycin and cladribine) and four compounds are currently being evaluated clinically (clofarabine, immucillin-H, nelarabine and 8-chloroadenosine). In addition, two gene therapy approaches are being evaluated that are based on the selective activation of purine nucleoside analogs (ganciclovir, fludarabine monophosphate and others) in tumor cells. Even though nucleoside analogs have been extensively evaluated over the last 50 years, the development of these new compounds demonstrates that there is still much promise in identifying new anticancer drugs from this class of compounds.