title: Vosaroxin: a new valuable tool with the potential to replace anthracyclines in the treatment of AML?
abstract: BACKGROUND
  Despite significant advances in diagnosis and supportive care, the majority of patients diagnosed with acute myeloid leukemia (AML) ultimately die of their disease. Standard intensive induction treatment continues to comprise cytarabine and a topoisomerase II (topo II) poison, usually an anthracycline. Vosaroxin , a novel first-in-class quinolone derivative has been developed for use in the treatment of AML as a new-generation topo II inhibitor. It has shown promising activity as a monotherapy and also in combination with intermediate dose cytarabine (IDAC) in relapsed and refractory patient cohorts with minimal toxicity and good tolerability.
  
  
  METHODS
  The authors discuss the mechanism of action of vosaroxin, the pharmacokinetics, safety and tolerability, preclinical and clinical trial results available as well as areas of ongoing research.
  
  
  CONCLUSIONS
  Vosaroxin has shown efficacy as a novel cytotoxic agent, and despite a similar mechanism of action has significant advantages over anthracyclines. It evades common resistance pathways of p53 and P-glycoprotein (P- gp) and does not appear to generate significant reactive oxygen species (ROS) associated with these agents. Should future investigation confirm its efficacy and advantageous safety profile, vosaroxin could potentially replace older generation topoisomerase poisons in the treatment of AML and other malignant conditions.
authors.affiliation: Department of Haematology, Pathology and Pharmacy Building, Barts and the London NHS Trust, 80 Newark Street, Whitechapel, E1 2ES, London, UK. freemanciara@yahoo.co.uk
authors.forename: Ciara
authors.initials: C
authors.lastname: Freeman
authors.forename: Niamh
authors.initials: N
authors.lastname: Keane
authors.forename: Ronan
authors.initials: R
authors.lastname: Swords
authors.forename: Francis
authors.initials: F
authors.lastname: Giles
mesh_terms: D018943:Anthracyclines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000378:metabolism; D009287:Naphthyridines / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D013844:Thiazoles / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D059005:Topoisomerase II Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D009287:Naphthyridines; D013844:Thiazoles; D059005:Topoisomerase II Inhibitors; C485113:vosaroxin