Antitumor antibiotics, epipodophyllotoxins, and vinca alkaloids: clinical developments

Abstract

New work over the past year has continued to evaluate new approaches to administration and modulation of these heavily used cytotoxic agents. Major themes reviewed here regarding antitumor antibiotics, epipodophyllotoxins, and vinca alkaloids are 1) increasing the dose intensity to determine if more administered drug is indeed better, 2) enhancing drug delivery to tumors by clinically testing drug carriers or regional delivery techniques, 3) development and clinical testing of new analogues designed to reduce important toxicities and to overcome resistance by enhanced potency, 4) modulation of clinical resistance by combining cytotoxic agents with pharmacologic modulators of multidrug resistance, and 5) exploitation of preclinical synergism with biologic agents.