Topoisomerase I (IC50 = 0.8 μM); Topoisomerase II (IC50 = 2.67 μM); Daunorubicins/Doxorubicins; HIV-1

体外活性：阿霉素是一种蒽环类抗生素，通常被认为在两个基本水平上发挥其抗肿瘤活性：改变 DNA 并产生自由基，通过 DNA 损伤引发癌细胞凋亡。阿霉素可以通过插入 DNA 链来阻断 DNA 的合成，并抑制 DNA 拓扑异构酶 II (TOP2)。当细胞快速增殖并表达高水平 TOP2 时，阿霉素最有效。此外，多柔比星还可以通过产生神经酰胺（通过激活 p53 或其他下游途径（例如 JNK）促进细胞凋亡）、丝氨酸苏氨酸蛋白酶降解 Akt、线粒体释放细胞色素 c、增加 FasL（死亡受体 Fas/CD95 配体）来触发细胞凋亡。 ) mRNA 的产生，以及自由基的产生。用 GSNO（亚硝基谷胱甘肽）预处理可抑制多柔比星耐药乳腺癌细胞系 MCF7/Dx 的耐药性，同时增强蛋白质谷胱甘肽化和多柔比星在细胞核中的积累。阿霉素诱导的 G2/M 检查点阻滞归因于细胞周期蛋白 G2 (CycG2) 表达升高以及共济失调毛细血管扩张突变 (ATM) 以及 ATM 和 Rad3 相关 (ATR) 信号通路中蛋白质的磷酸化修饰。阿霉素抑制 AMP 激活蛋白激酶 (AMPK)，导致 SIRT1 功能障碍、p53 积累以及小鼠胚胎成纤维细胞 (MEF) 和心肌细胞的细胞死亡增加，而 AMPK 的预抑制可进一步使其敏化。阿霉素引起显着的热休克反应，并且抑制或沉默热休克蛋白可增强阿霉素在神经母细胞瘤细胞中的凋亡作用。在没有可测量的蛋白酶体抑制的情况下，纳摩尔多柔比星治疗神经母细胞瘤细胞会导致一组特定蛋白质发生剂量依赖性过度泛素化，并导致泛素化酶（如乳酸脱氢酶和 α-烯醇酶）活性丧失，其蛋白质泛素化模式与蛋白酶体抑制剂硼替佐米相似，表明阿霉素也可能通过破坏蛋白质来发挥作用。细胞测定：用增加浓度的阿霉素（0.1、0.3、0.5和1.0 μg/ml，分别等于0.17、0.52、0.85和1.71 μM）处理H9c2细胞2小时，或用0.3 μg/ml（等于0.52μM）的阿霉素在不同的时间点。 Doxorubicin 以时间和剂量依赖性方式诱导 AMPKα (Thr 172) 及其下游乙酰辅酶 A 羧化酶 (ACC、Ser 79) 强烈磷酸化。 AMPKα 磷酸化在多柔比星处理 1 小时后变得明显，并进一步持续至少 6 小时。 LKB1（AMPK 可能的上游激酶）在 H9c2 细胞中也被阿霉素激活。

在体内，阿霉素与腺病毒 MnSOD (AdMnSOD) 加 1,3-双(2-氯乙基)-1-亚硝基脲 (BCNU) 联合使用，在减少 MB231 肿瘤体积和延长小鼠存活方面具有最大效果。尽管其使用受到其产生的慢性和急性毒副作用的限制，但阿霉素对于治疗乳腺癌和食道癌、儿童实体瘤、骨肉瘤、卡波西肉瘤、软组织肉瘤以及霍奇金和非霍奇金淋巴瘤至关重要。

纯化的人DNA拓扑异构酶I通过在0-2.0μM阿霉素存在下用超螺旋pHC624 DNA进行酶滴定来定量测定。在溴化乙锭存在下，通过琼脂糖凝胶电泳解析超螺旋和松弛的DNA，并通过扫描微密度测定法定量超螺旋DNA转化为松弛DNA的百分比。在不同浓度的阿霉素下测量DNA拓扑异构酶I活性的抑制作用。阿霉素在0.8微M的IC50值（抑制总活性的50%所需的浓度）下抑制酶活性。对结构相关的蒽环类抗肿瘤药物柔红霉素也观察到类似的抑制作用。这些结果表明，蒽环类药物在体内引起DNA损伤和细胞毒性的浓度下抑制人类DNA拓扑异构酶I活性[11]。

细胞培养[7]
LS141原代人细胞系来源于患有高级腹膜后去分化脂肪肉瘤的患者，MPNST细胞来源于患有大腿高级周围神经鞘肿瘤的患者。这些生长在补充有15%热灭活胎牛血清加青霉素和链霉素的RPMI1640中。[7]
菌落测定[7]
MPNST细胞依次用阿霉素、黄必利或这两种药物的组合处理。选择MPNST细胞是因为LS141（和其他CDK4依赖性）细胞在体外对CDK4抑制非常敏感，因此组合研究是不间断的。MPNST细胞以每板1000个细胞/100 mm2的密度进行三次接种。接种24小时后，用阿霉素（D，15nM）、黄必利（F，150nM）的IC50、无药物培养基（对照）或两种药物的组合同时或依次处理细胞24小时。处理后，去除含药物的培养基，并使细胞生长10天以形成集落。将所得菌落用0.01%结晶紫染色30分钟，并使用自动菌落计数器计数菌落。结果以未治疗对照的百分比表示，实验结果的统计学意义通过双侧t检验确定。

Female athymic nude mice injected s.c. with MB231 cells; 3 mg/kg/day; Delivered intratumorly
Female athymic nude mice injected s.c. with MB231 cells

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In vivo studies LS141 xenografts were established by directly implanting into severe combined immunodeficient (SCID) mice. Once tumors reached 100 mm3 , groups of five mice were treated with the maximum tolerated dose (MTD) of flavopiridol (9 mg/kg), doxorubicin (0.9 mg/kg), or doxorubicin (0.7 mg/kg) followed by flavopiridol (7 mg/kg) at selected time points (1, 4 and 7 hours). In addition, one set of animals was treated in reverse order of flavopiridol followed by doxorubicin, administered 7 hours apart. All treatments were administered in intraperitoneal fashion, twice weekly, for a total of 5 treatments. Tumors were measured every 2 to 3 days with calipers, and tumor volumes were calculated by the formula π/ 6 × (large diameter) × (small diameter)2. Tumor volume was compared between groups of mice at various points in time based on the experiment and the statistical significance of the experimental results was determined by the two-sided t test. Given the aggressive morbidity of the tumors, animal survival data could not be estimated. Toxicity was monitored by weight loss. These studies were done in accordance with the Principles of Laboratory Animal Care, under an IACUC-approved protocol.

Absorption, Distribution and Excretion
Following a 10 mg/m2 administration of liposomal doxorubicin in patients with AIDS-related Kaposi's Sarcoma, the Cmax and AUC values were calculated to be 4.12 ± 0.215 μg/mL and 277 ± 32.9 μg/mL•h respectively.
Approximately 40% of the dose appears in the bile in 5 days, while only 5% to 12% of the drug and its metabolites appear in the urine during the same time period. In urine, <3% of the dose was recovered as doxorubicinol over 7 days.
The steady-state distribution volume of doxorubicin ranges from 809 L/m² to 1214 L/m².
The plasma clearance of doxorubicin ranges from 324 mL/min/m2 to 809 mL/min/m² by metabolism and biliary excretion. Sexual differences in doxorubicin were also observed, with men having a higher clearance compared to women (1088 mL/min/m² versus 433 mL/min/m²). Following the administration of doses ranging from 10 mg/m2 to 75 mg/m² of doxorubicin hydrochloride, the plasma clearance was estimated to be 1540 mL/min/m² in children greater than 2 years of age and 813 mL/min/m² in infants younger than 2 years of age.
Nonencapsulated doxorubicin hydrochloride is not stable in gastric acid, and animal studies indicate that the drug undergoes little, if any, absorption from the GI tract. The drug is extremely irritating to tissues and, therefore, must be administered iv. Following iv infusion of a single 10- or 20-mg/sq m dose of liposomal doxorubicin hydrochloride in patients with AIDS-related Kaposi's sarcoma, average peak plasma doxorubicin (mostly bound to liposomes) concentrations are 4.33 or 10.1 ug/mL, respectively, following a 15-minute infusion and 4.12 or 8.34 ug/mL, respectively, following a 30-minute infusion. Following iv infusion over 15 minutes of a 40-mg/sq m dose of liposomal doxorubicin hydrochloride in adults with AIDS-related Kaposi's, peak plasma concentrations averaged 20.1 ug/mL.
Nonencapsulated (conventional) doxorubicin hydrochloride exhibits linear pharmacokinetics; PEG-stabilized liposomal doxorubicin hydrochloride also exhibits dose-proportional, linear pharmacokinetics over a dosage range of 10-20 mg/sq m. The pharmacokinetics of liposomally encapsulated doxorubicin at a dose of 50 mg/sq m have been reported to be nonlinear. At a dose of 50 mg/sq m, a longer elimination half-life and lower clearance compared to those observed with a 20 mg/sq m dose are expected, with greater-than-proportional increases in area under the plasma concentration-time curve. Encapsulation of doxorubicin hydrochloride in PEG-stabilized (Stealth) liposomes substantially alters the pharmacokinetics of the drug relative to conventional iv formulations (ie, nonencapsulated drug), with resultant decreased distribution into the peripheral compartment, increased distribution into Kaposi's lesions, and decreased plasma clearance.
Doxorubicin administered as a conventional injection is widely distributed in the plasma and in tissues. As early as 30 seconds after iv administration, doxorubicin is present in the liver, lungs, heart, and kidneys. Doxorubicin is absorbed by cells and binds to cellular components, particularly to nucleic acids. The volume of distribution of doxorubicin hydrochloride administered iv as a conventional injection is about 700-1100 L/sq m. Nonencapsulated doxorubicin is approximately 50-85% bound to plasma proteins...
Doxorubicin hydrochloride administered iv as the liposomally encapsulated drug distributes into Kaposi's sarcoma lesions to a greater extent than into healthy skin. Following iv administration of a single 20-mg/sq m dose of liposomal doxorubicin hydrochloride, doxorubicin concentrations in Kaposi's sarcoma lesions were 19 (range: 3-53)-fold higher than those observed in healthy skin; however, blood concentrations in the lesions or in healthy skin were not considered. In addition, distribution of doxorubicin into Kaposi's sarcoma lesions following iv administration of liposomally encapsulated drug was 5.2-11.4 times greater than that following iv administration of comparable doses of a conventional (nonencapsulated) injection. The mechanism by which liposomal encapsulation enhances doxorubicin distribution into Kaposi's sarcoma lesions has not been elucidated fully, but similar PEG-stabilized liposomes containing colloidal gold as a marker have been shown to enter Kaposi's sarcoma-like lesions in animals. Extravasation of the liposomes also may occur by passage of the particles through endothelial cell gaps present in Kaposi's sarcoma. Once within the lesions, the drug presumably is released locally as the liposomes degrade and become permeable in situ.
For more Absorption, Distribution and Excretion (Complete) data for DOXORUBICIN (16 total), please visit the HSDB record page.

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Metabolism / Metabolites
Doxorubicin is capable of undergoing 3 metabolic routes: one-electron reduction, two-electron reduction, and deglycosidation. However, approximately half of the dose is eliminated from the body unchanged. The two-electron reduction is the major metabolic pathway of doxorubicin. In this pathway, doxorubicin is reduced to doxorubicinol, a secondary alcohol, by various enzymes, including Alcohol dehydrogenase [NADP(+)], Carbonyl reductase [NADPH] 1, Carbonyl reductase [NADPH] 3, and Aldo-keto reductase family 1 member C3. The one-electron reduction is facilitated by several oxidoreductase, both cytosolic and mitochondrial, to form a doxirubicin-semiquinone radical. These enzymes include mitochondrial and cystolic NADPH dehydrogenates, xanthine oxidase, and nitric oxide synthases. This semiquinone metabolite can be re-oxidized to doxorubicin, although with the concurrent formation of reactive oxygen species (ROS) and hydrogen peroxide. It is the ROS generating through this pathway that contributes most to the doxorubicin-related adverse effects, particularly cardiotoxicity, rather than through doxorubicin semiquinone formation. Deglycosidation is a minor metabolic pathway, since it only accounts for 1 to 2% of doxorubicin metabolism. Under the catalysis of cytoplasmic NADPH quinone dehydrogenase, xanthine oxidase, NADPH-cytochrome P450 reductase, doxorubicin can either be reduced to doxorubicin deoxyaglycone or hydrolyzed to doxorubicin hydroxyaglycone.
Nonencapsulated doxorubicin is metabolized by NADPH-dependent aldoketoreductases to the hydrophilic 13-hydroxyl metabolite doxorubicinol, which exhibits antineoplastic activity and is the major metabolite; these reductases are present in most if not all cells, but particularly in erythrocytes, liver, and kidney. Although not clearly established, doxorubicinol also appears to be the moiety responsible for the cardiotoxic effects of the drug. Undetectable or low plasma concentrations (ie, 0.8-26.2 ng/mL) of doxorubicinol have been reported following iv administration of a single 10- to 50-mg/sq m dose of doxorubicin hydrochloride as a PEG-stabilized liposomal injection; it remains to be established whether such liposomally encapsulated anthracyclines are less cardiotoxic than conventional (nonencapsulated) drug, and the usual precautions for unencapsulated drug currently also should be observed for the liposomal preparation. Substantially reduced or absent plasma concentrations of the usual major metabolite of doxorubicin observed with the PEG-stabilized liposomal injection suggests that either the drug is not released appreciably from the liposomes as they circulate or that some doxorubicin may be released but that the rate of doxorubicinol elimination greatly exceeds the release rate; doxorubicin hydrochloride encapsulated in liposomes that have not been PEG-stabilized is metabolized to doxorubicinol.
Other metabolites, which are therapeutically inactive, include the poorly water-soluble aglycones, doxorubicinone (adriamycinone) and 7-deoxydoxorubicinone (17-deoxyadriamycinone), and conjugates. The aglycones are formed in microsomes by NADPH-dependent, cytochrome reductase-mediated cleavage of the amino sugar moiety. The enzymatic reduction of doxorubicin to 7-deoxyaglycones is important to the cytotoxic effect of the drug since it results in hydroxyl radicals that cause extensive cell damage and death. With nonencapsulated doxorubicin, more than 20% of the total drug in plasma is present as metabolites as soon as 5 minutes after a dose, 70% in 30 minutes, 75% in 4 hours, and 90% in 24 hours.
... At least 6 metabolites have been identified, the principal one being adriamycinol. This product results from redn of the keto group on C13 by an enzyme found in leukocytes and erythrocytes, and presumably in malignant tissues.
Doxorubicin is converted to doxorubicinol, to aglycones, and to other derivatives
For more Metabolism/Metabolites (Complete) data for DOXORUBICIN (6 total), please visit the HSDB record page.
Doxorubicin is capable of undergoing 3 metabolic routes: one-electron reduction, two-electron reduction, and deglycosidation. However, approximately half of the dose is eliminated from the body unchanged. Two electron reduction yields doxorubicinol, a secondary alcohol. This pathway is considered the primary metabolic pathway. The one electron reduction is facilitated by several oxidoreductases to form a doxirubicin-semiquinone radical. These enzymes include mitochondrial and cystolic NADPH dehydrogenates, xanthine oxidase, and nitric oxide synthases. Deglycosidation is a minor metabolic pathway (1-2% of the dose undergoes this pathway). The resultant metabolites are deoxyaglycone or hydroxyaglycone formed via reduction or hydrolysis respectively. Enzymes that may be involved with this pathway include xanthine oxidase, NADPH-cytochrome P450 reductase, and cytosolic NADPH dehydrogenase.
Route of Elimination: 40% of the dose appears in bile in 5 days. 5-12% of the drug and its metabolites appears in urine during the same time period. <3% of the dose recovered in urine was doxorubicinol.
Half Life: Terminal half life = 20 - 48 hours.

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Biological Half-Life
The terminal half-life of doxorubicin ranges from 20 hours to 48 hours. The distribution half-life of doxorubicin is approximately 5 minutes. For the liposomal formulation, the first-phase and second-phase half-lives were calculated to be 4.7 ± 1.1 and 52.3 ± 5.6 hours respectively for a 10 mg/m² of doxorubicin in patients with AIDS-Related Kaposi’s Sarcoma.
Plasma concentrations of nonencapsulated doxorubicin and its metabolites decline in a biphasic or triphasic manner. In the first phase of the triphasic model, nonencapsulated doxorubicin is rapidly metabolized, presumably by a first-pass effect through the liver. It appears that most of this metabolism is completed before the entire dose is administered. In the triphasic model, nonencapsulated doxorubicin and its metabolites are rapidly distributed into the extravascular compartment with a plasma half-life of approximately 0.2-0.6 hours for doxorubicin and 3.3 hours for its metabolites. This is followed by relatively prolonged plasma concentrations of doxorubicin and its metabolites, probably resulting from tissue binding. During the second phase, the plasma half-life of nonencapsulated doxorubicin is 16.7 hours and that of its metabolites is 31.7 hours. In the biphasic model, the initial distribution t1/2 has been reported to average about 5-10 minutes, and the terminal elimination t1/2 has been reported to average about 30 hours.
Plasma concentrations of liposomally encapsulated doxorubicin hydrochloride appear to decline in a biphasic manner. Following iv administration of a single 10- to 40-mg/sq m dose of doxorubicin hydrochloride as a liposomal injection in patients with AIDS-related Kaposi's sarcoma, the initial plasma half-life (t1/2 alpha) of doxorubicin averaged 3.76-5.2 hours while the terminal elimination half-life (t1/2 beta) averaged 39.1-55 hours.
The initial distribution half-life of approximately 5 minutes suggests rapid tissue uptake of doxorubicin, while its slow elimination from tissues is reflected by a terminal half-life of 20 to 48 hours.
Plasma T/2 of Adriamycin is about 17 hr in patient, whereas that of its metabolites is about 32 hr.

The chemotherapeutic agent doxorubicin (DOX) is associated with a dose-dependent cardiotoxicity that can eventuate into heart failure. This study aimed to characterize the onset and degree of cardiotoxicity in rats receiving 10 mg/kg DOX administered as a single intraperitoneal injection (DOX1), 10 daily intraperitoneal injections of 1 mg/kg (DOX2), or in 5 weekly intraperitoneal injections of 2 mg/kg (DOX3). Transthoracic echocardiography measurements were recorded every week to characterize the onset and degree of cardiotoxicity in the 3 groups. An 80% mortality rate was observed at day 28 in DOX1, whereas DOX2 and DOX3 reached 80% mortality at days 107 and 98, respectively. Fractional shortening decreased by 30% at week 2 in DOX1, 55% at week 13 in DOX2, and 42% at week 13 in DOX3. In addition, cardiac function clearly differed between DOX1 and DOX3, whereas DOX2 and DOX3 were similar. These findings indicate that administration of the dose over the course of days (DOX2) or weeks (DOX3) results in a better survival rate and more classic signs of DOX-induced dilated cardiomyopathy, albeit with later onset, as compared with a single 10 mg/kg bolus injection of DOX.[J Am Assoc Lab Anim Sci. 2007 Jul;46(4):20-32.]

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Effects During Pregnancy and Lactation
◉ Summary of Use during Lactation
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, especially anthracyclines such as doxorubicin. It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence; however, the high levels and persistence of the active metabolite doxorubicinol in milk make defining an appropriate abstinence interval difficult. Some have suggested a breastfeeding abstinence period of 5 to 10 days after a dose. More recent pharmacokinetic modeling using a worst-case scenario suggests that 13 days would be required to minimize both systemic and gut toxicity after the colostral phase.
Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk. Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.
◉ Effects in Breastfed Infants
A woman was diagnosed with B-cell lymphoma at 27 weeks of pregnancy. Labor was induced at 34 4/7 weeks and treatment was begun with a standard regimen of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone in unspecified doses on a 21-day cycle, starting on day 2 postpartum. She pumped and discarded her milk and fed her infant donor milk for the first 10 days of each cycle and then breastfed her infant for the remaining 10 days before the next treatment cycle. The 10-day period of breastfeeding abstinence was determined by using about 3 half-lives of vincristine. After completion of 4 cycles of chemotherapy, her infant was reportedly healthy and developing without any complications.
◉ Effects on Lactation and Breastmilk
A study of adolescent males who had received chemotherapy for childhood malignancies found that having received doxorubicin was associated with elevated serum prolactin concentrations.
A woman diagnosed with Hodgkin's lymphoma during the second trimester of pregnancy received 3 rounds of chemotherapy during the third trimester of pregnancy and resumed chemotherapy 4 weeks postpartum. Milk samples were collected 15 to 30 minutes before and after chemotherapy for 16 weeks after restarting. The regimen consisted of doxorubicin 40 mg, bleomycin 16 units, vinblastine 9.6 mg and dacarbazine 600 mg, all given over a 2-hour period every 2 weeks. The microbial population and metabolic profile of her milk were compared to those of 8 healthy women who were not receiving chemotherapy. The breastmilk microbial population in the patient was markedly different from that of the healthy women, with increases in Acinetobacter sp., Xanthomonadacae and Stenotrophomonas sp. and decreases in Bifidobacterium sp. and Eubacterium sp. Marked differences were also found among numerous chemical components in the breastmilk of the treated woman, most notably DHA and inositol were decreased.
A telephone follow-up study was conducted on 74 women who received cancer chemotherapy at one center during the second or third trimester of pregnancy to determine if they were successful at breastfeeding postpartum. Only 34% of the women were able to exclusively breastfeed their infants, and 66% of the women reported experiencing breastfeeding difficulties. This was in comparison to a 91% breastfeeding success rate in 22 other mothers diagnosed during pregnancy, but not treated with chemotherapy. Other statistically significant correlations included: 1. mothers with breastfeeding difficulties had an average of 5.5 cycles of chemotherapy compared with 3.8 cycles among mothers who had no difficulties; and 2. mothers with breastfeeding difficulties received their first cycle of chemotherapy on average 3.4 weeks earlier in pregnancy. Of the 62 women who received a doxorubicin-containing regimen, 39 had breastfeeding difficulties.

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Doxorubicin Hydrochloride (Adriamycin) can cause cancer according to an independent committee of scientific and health experts. It can cause developmental toxicity and male reproductive toxicity according to state or federal government labeling requirements.
Adriamycin hydrochloride appears as orange-red thin needles. Aqueous solutions yellow-orange at acid pHs, orange-red at neutral pHs, and violet blue over pH 9. (NTP, 1992)
Doxorubicin hydrochloride is an anthracycline.
Doxorubicin hydrochloride (liposomal) is an antineoplastic prescription medicine approved by the U.S. Food and Drug Administration (FDA) for the treatment of certain types of cancer, including ovarian cancer, multiple myeloma, and AIDS-related Kaposi sarcoma.
Kaposi sarcoma is caused by infection with human herpesvirus-8 (HHV-8). HHV-8 infection can be an opportunistic infection (OI) of HIV.
Doxorubicin Hydrochloride is the hydrochloride salt of doxorubicin, an anthracycline antibiotic with antineoplastic activity. Doxorubicin, isolated from the bacterium Streptomyces peucetius var. caesius, is the hydroxylated congener of daunorubicin. Doxorubicin intercalates between base pairs in the DNA helix, thereby preventing DNA replication and ultimately inhibiting protein synthesis. Additionally, doxorubicin inhibits topoisomerase II which results in an increased and stabilized cleavable enzyme-DNA linked complex during DNA replication and subsequently prevents the ligation of the nucleotide strand after double-strand breakage. Doxorubicin also forms oxygen free radicals resulting in cytotoxicity secondary to lipid peroxidation of cell membrane lipids; the formation of oxygen free radicals also contributes to the toxicity of the anthracycline antibiotics, namely the cardiac and cutaneous vascular effects.
Antineoplastic antibiotic obtained from Streptomyces peucetius. It is a hydroxy derivative of DAUNORUBICIN.
See also: Doxorubicin (has active moiety).

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Drug Indication
Celdoxome pegylated liposomal is indicated in adults: as monotherapy for patients with metastatic breast cancer , where there is an increased cardiac risk. or treatment of advanced ovarian cancer in women who have failed a first-line platinum-based chemotherapy regimen. in combination with bortezomib for the treatment of progressive multiple myeloma in patients who have received at least one prior therapy and who have already undergone or are unsuitable for bone marrow transplant. for treatment of AIDS-related Kaposi's sarcoma (KS) in patients with low CD4 counts (< 200 CD4 lymphocytes/mm3) and extensive mucocutaneous or visceral disease. Celdoxome pegylated liposomal may be used as first-line systemic chemotherapy, or as second line chemotherapy in AIDS-KS patients with disease that has progressed with, or in patients intolerant to, prior combination systemic chemotherapy comprising at least two of the following agents: a vinca alkaloid, bleomycin and standard doxorubicin (or other anthracycline).
Caelyx pegylated liposomal is indicated: as monotherapy for patients with metastatic breast cancer , where there is an increased cardiac risk; for treatment of advanced ovarian cancer in women who have failed a first-line platinum-based chemotherapy regimen; in combination with bortezomib for the treatment of progressive multiple myeloma in patients who have received at least one prior therapy and who have already undergone or are unsuitable for bone marrow transplant; for treatment of AIDS-related Kaposi's sarcoma (KS) in patients with low CD4 counts (
Myocet liposomal, in combination with cyclophosphamide, is indicated for the first-line treatment of metastatic breast cancer in adult women.
Treatment of breast and ovarian cancer .
Treatment of hepatocellular carcinoma

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Doxorubicin is a deoxy hexoside, an anthracycline, an anthracycline antibiotic, an aminoglycoside, a member of tetracenequinones, a member of p-quinones, a primary alpha-hydroxy ketone and a tertiary alpha-hydroxy ketone. It has a role as an Escherichia coli metabolite. It is a conjugate base of a doxorubicin(1+). It derives from a hydride of a tetracene.
Doxorubicin hydrochloride (liposomal) is an antineoplastic prescription medicine approved by the U.S. Food and Drug Administration (FDA) for the treatment of certain types of cancer, including ovarian cancer, multiple myeloma, and AIDS-related Kaposi sarcoma.
Kaposi sarcoma is caused by infection with human herpesvirus-8 (HHV-8). HHV-8 infection can be an opportunistic infection (OI) of HIV.
Doxorubicin is a cytotoxic anthracycline antibiotic isolated from cultures of Streptomyces peucetius var. caesius along side with daunorubicin, another cytotoxic agent, in 1970. Although they both have aglyconic and sugar moieties, doxorubicin's side chain terminates with a primary alcohol group compared to the methyl group of daunorubicin. Although its detailed molecular mechanisms have yet to be understood, doxorubicin is generally thought to exert its effect through DNA intercalation, which eventually leads to DNA damage and the generation of reactive oxygen species. Thanks to its efficacy and broad effect, doxorubicin was approved by the FDA in 1974 to treat a variety of cancer, including but not limited to breast, lung, gastric, ovarian, thyroid, non-Hodgkin’s and Hodgkin’s lymphoma, multiple myeloma, sarcoma, and pediatric cancers. However, one of the major side effects of doxorubicin is cardiotoxicity, which excludes patients with poor heart function and requires treatment termination once the maximally tolerated cumulative dose is reached.
Doxorubicin is an Anthracycline Topoisomerase Inhibitor. The mechanism of action of doxorubicin is as a Topoisomerase Inhibitor.
Doxorubicin has been reported in Talaromyces aculeatus, Hamigera fusca, and other organisms with data available.
Doxorubicin is an anthracycline antibiotic with antineoplastic activity. Doxorubicin, isolated from the bacterium Streptomyces peucetius var. caesius, is the hydroxylated congener of daunorubicin. Doxorubicin intercalates between base pairs in the DNA helix, thereby preventing DNA replication and ultimately inhibiting protein synthesis. Additionally, doxorubicin inhibits topoisomerase II which results in an increased and stabilized cleavable enzyme-DNA linked complex during DNA replication and subsequently prevents the ligation of the nucleotide strand after double-strand breakage. Doxorubicin also forms oxygen free radicals resulting in cytotoxicity secondary to lipid peroxidation of cell membrane lipids; the formation of oxygen free radicals also contributes to the toxicity of the anthracycline antibiotics, namely the cardiac and cutaneous vascular effects.
Doxorubicin is only found in individuals that have used or taken this drug. It is antineoplastic antibiotic obtained from Streptomyces peucetius. It is a hydroxy derivative of daunorubicin. [PubChem]Doxorubicin has antimitotic and cytotoxic activity through a number of proposed mechanisms of action: Doxorubicin forms complexes with DNA by intercalation between base pairs, and it inhibits topoisomerase II activity by stabilizing the DNA-topoisomerase II complex, preventing the religation portion of the ligation-religation reaction that topoisomerase II catalyzes.
Antineoplastic antibiotic obtained from Streptomyces peucetius. It is a hydroxy derivative of DAUNORUBICIN.
See also: Doxorubicin Hydrochloride (has salt form); Zoptarelin Doxorubicin (is active moiety of); Zoptarelin Doxorubicin Acetate (is active moiety of).

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Drug Indication
Doxorubicin is indicated for the treatment of neoplastic conditions like acute lymphoblastic leukemia, acute myeloblastic leukemia, Hodgkin and non-Hodgkin lymphoma, metastatic breast cancer, metastatic Wilms’ tumor, metastatic neuroblastoma, metastatic soft tissue and bone sarcomas, metastatic ovarian carcinoma, metastatic transitional cell bladder carcinoma, metastatic thyroid carcinoma, metastatic gastric carcinoma, and metastatic bronchogenic carcinoma. Doxorubicin is also indicated for use as a component of adjuvant therapy in women with evidence of axillary lymph node involvement following resection of primary breast cancer. For the liposomal formulation, doxorubicin is indicated for the treatment of ovarian cancer that has progressed or recurred after platinum-based chemotherapy, AIDS-Related Kaposi's Sarcoma after the failure of prior systemic chemotherapy or intolerance to such therapy, and multiple myeloma in combination with bortezomib in patients who have not previously received bortezomib and have received at least one prior therapy.
FDA Label
Zolsketil pegylated liposomal is a medicine used to treat the following types of cancer in adults: • breast cancer that has spread to other parts of the body in patients at risk of heart problems. Zolsketil pegylated liposomal is used on its own for this disease; • advanced ovarian cancer in women whose previous treatment including a platinum-based cancer medicine has stopped working; • multiple myeloma (a cancer of the white blood cells in the bone marrow), in patients with progressive disease who have received at least one other treatment in the past and have already had, or are unsuitable for, a bone marrow transplantation. Zolsketil pegylated liposomal is used in combination with bortezomib (another cancer medicine); • Kaposi's sarcoma in patients with AIDS who have a very damaged immune system. Kaposi's sarcoma is a cancer that causes abnormal tissue to grow under the skin, on moist body surfaces or on internal organs. Zolsketil pegylated liposomal contains the active substance doxorubicin and is a ‘hybrid medicine'. This means that it is similar to a ‘reference medicine' containing the same active substance called Adriamycin. However, in Zolsketil pegylated liposomal the active substance is enclosed in tiny fatty spheres called liposomes, whereas this is not the case for Adriamycin.
Caelyx pegylated liposomal is indicated: as monotherapy for patients with metastatic breast cancer , where there is an increased cardiac risk; for treatment of advanced ovarian cancer in women who have failed a first-line platinum-based chemotherapy regimen; in combination with bortezomib for the treatment of progressive multiple myeloma in patients who have received at least one prior therapy and who have already undergone or are unsuitable for bone marrow transplant; for treatment of AIDS-related Kaposi's sarcoma (KS) in patients with low CD4 counts (
Myocet liposomal, in combination with cyclophosphamide, is indicated for the first-line treatment of metastatic breast cancer in adult women.
Treatment of breast and ovarian cancer .

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Mechanism of Action
Generally, doxorubicin is thought to exert its antineoplastic activity through 2 primary mechanisms: intercalation into DNA and disrupt topoisomerase-mediated repairs and free radicals-mediated cellular damages. Doxorubicin can intercalate into DNA through the anthraquinone ring, which stabilizes the complex by forming hydrogen bonds with DNA bases. Intercalation of doxorubicin can introduce torsional stress into the polynucleotide structure, thus destabilizing nucleosome structures and leading to nucleosome eviction and replacement. Additionally, the doxorubicin-DNA complex can interfere with topoisomerase II enzyme activity by preventing relegation of topoisomerase-mediated DNA breaks, thus inhibiting replication and transcription and inducing apoptosis. Moreover, doxorubicin can be metabolized by microsomal NADPH-cytochrome P-450 reductase into a semiquinone radical, which can be reoxidized in the presence of oxygen to form oxygen radicals. Reactive oxygen species have been known to cause cellular damage through various mechanisms, including lipid peroxidation and membrane damage, DNA damage, oxidative stress, and apoptosis. Although free radicals generated from this pathway can be deactivated by catalase and superoxide dismutase, tumor and myocardial cells tend to lack these enzymes, thus explaining doxorubicin's effectiveness against cancer cells and tendency to cause cardiotoxicity.
Doxorubicin hydrochloride is an antineoplastic antibiotic with pharmacologic actions similar to those of daunorubicin. Although the drug has anti-infective properties, its cytotoxicity precludes its use as an anti-infective agent. The precise and/or principal mechanism(s) of the antineoplastic action of doxorubicin is not fully understood. It appears that the cytotoxic effect of the drug results from a complex system of multiple modes of action related to free radical formation secondary to metabolic activation of the doxorubicin by electron reduction, intercalation of the drug into DNA, induction of DNA breaks and chromosomal aberrations, and alterations in cell membranes induced by the drug. Evidence from in vitro studies in cells treated with doxorubicin suggests that apoptosis (programmed cell death) also may be involved in the drug's mechanism of action. These and other mechanisms (chelation of metal ions to produce drug-metal complexes) also may contribute to the cardiotoxic effects of the drug.
Doxorubicin undergoes enzymatic 1- and 2-electron reduction to the corresponding semiquinone and dihydroquinone. 7-Deoxyaglycones are formed enzymatically by 1-electron reduction, and the resulting semiquinone free radical reacts with oxygen to produce the hydroxyl radical in a cascade of reactions; this radical may lead to cell death by reacting with DNA, RNA, cell membranes, and proteins. The dihydroquinone that results from 2-electron reduction of doxorubicin also can be formed by the reaction of 2 semiquinones. In the presence of oxygen, dihydroquinone reacts to form hydrogen peroxide, and in its absence, loses its sugar and gives rise to the quinone methide, a monofunctional alkylating agent with low affinity for DNA. The contribution of dihydroquinone and the quinone methide to the cytotoxicity of doxorubicin is unclear. Experimental evidence indicates that doxorubicin forms a complex with DNA by intercalation between base pairs, causing inhibition of DNA synthesis and DNA-dependent RNA synthesis by the resulting template disordering and steric obstruction. Doxorubicin also inhibits protein synthesis. Doxorubicin is active throughout the cell cycle including the interphase.
Several anthracycline-induced effects may contribute to the development of cardiotoxicity. In animals, anthracyclines cause a selective inhibition of cardiac muscle gene expression for ?-actin, troponin, myosin light-chain 2, and the M isoform of creatine kinase, which may result in myofibrillar loss associated with anthracycline-induced cardiotoxicity. Other potential causes of anthracycline-induced cardiotoxicity include myocyte damage from calcium overload, altered myocardial adrenergic function, release of vasoactive amines, and proinflammatory cytokines. Limited data indicate that calcium-channel blocking agents (eg, prenylamine) or beta-adrenergic blocking agents may prevent calcium overload ... It has been suggested that the principal cause of anthracycline-induced cardiotoxicity is associated with free radical damage to DNA.
Anthracyclines intercalate DNA, chelate metal ions to produce drug-metal complexes, and generate oxygen free radicals via oxidation-reduction reactions. Anthracyclines contain a quinone structure that may undergo reduction via NADPH-dependent reactions to produce a semiquinone free radical that initiates a cascade of oxygen-free radical generation. It appears that the metabolite, doxorubicinol, may be the moiety responsible for cardiotoxic effects, and the heart may be particularly susceptible to free-radical injury because of relatively low antioxidant concentrations. ... Chelation of metal ions, particularly iron, by the drug results in a doxorubicin-metal complex that catalyzes the generation of reactive oxygen free radicals, and the complex is a powerful oxidant that can initiate lipid peroxidation in the absence of oxygen free radicals. This reaction is not blocked by free-radical scavengers, and probably is the principal mechanism of anthracycline-induced cardiotoxicity.
The effect of doxorubicin on reactive oxygen metb in rat heart was investigated. It produced oxygen radicals in heart homogenate, sarcoplasmic reticulum, mitochondria, and cytosol, the major sites of cardiac damage. Superoxide prodn in heart sarcosomes and the mitochondrial fraction was incr. Apparently, free radical formation by doxorubicin, which occurs in the same myocardial compartments that are subject to drug-induced tissue injury, may damage the heart by exceeding the oxygen radical detoxifying capacity of cardiac mitochondria and sarcoplasmic reticulum.

C27H29NO11.HCL

579.98

579.15

C, 55.91; H, 5.21; Cl, 6.11; N, 2.42; O, 30.34

25316-40-9

25316-40-9 (Doxorubicin HCl); 23214-92-8

443939

Red to orange solid powder

810.3ºC at 760 mmHg

216ºC

443.8ºC

9.64E-28mmHg at 25°C

Streptomyces peucetius var. Caesius

1.503

206.07

7

12

5

40

977

6

Cl[H].O([C@@]1([H])C([H])([H])[C@@]([H])([C@@]([H])([C@]([H])(C([H])([H])[H])O1)O[H])N([H])[H])[C@]1([H])C2C(=C3C(C4C(=C([H])C([H])=C([H])C=4C(C3=C(C=2C([H])([H])[C@@](C(C([H])([H])O[H])=O)(C1([H])[H])O[H])O[H])=O)OC([H])([H])[H])=O)O[H]

MWWSFMDVAYGXBV-RUELKSSGSA-N

InChI=1S/C27H29NO11.ClH/c1-10-22(31)13(28)6-17(38-10)39-15-8-27(36,16(30)9-29)7-12-19(15)26(35)21-20(24(12)33)23(32)11-4-3-5-14(37-2)18(11)25(21)34;/h3-5,10,13,15,17,22,29,31,33,35-36H,6-9,28H2,1-2H3;1H/t10-,13-,15-,17-,22+,27-;/m0./s1

(7S,9S)-7-[(2R,4S,5S,6S)-4-amino-5-hydroxy-6-methyloxan-2-yl]oxy-6,9,11-trihydroxy-9-(2-hydroxyacetyl)-4-methoxy-8,10-dihydro-7H-tetracene-5,12-dione;hydrochloride

2934.99.9001

Powder      -20°C    3 years

                     4°C     2 years

In solvent   -80°C    6 months

                  -20°C    1 month

注意： 请将本产品存放在密封且受保护的环境中（例如氮气保护），避免吸湿/受潮和光照。

Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)

配方 1 中的溶解度: ≥ 2.75 mg/mL (4.74 mM) (饱和度未知) in 5% DMSO + 40% PEG300 + 5% Tween80 + 50% Saline (这些助溶剂从左到右依次添加，逐一添加), 澄清溶液。
*生理盐水的制备：将 0.9 g 氯化钠溶解在 100 mL ddH₂O中，得到澄清溶液。

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配方 2 中的溶解度: ≥ 2.08 mg/mL (3.59 mM) (饱和度未知) in 10% DMSO + 40% PEG300 + 5% Tween80 + 45% Saline (这些助溶剂从左到右依次添加，逐一添加), 澄清溶液。
例如，若需制备1 mL的工作液，可将 100 μL 20.8 mg/mL澄清的DMSO储备液加入到400 μL PEG300中，混匀；再向上述溶液中加入50 μL Tween-80，混匀；然后加入450 μL生理盐水定容至1 mL。
*生理盐水的制备：将 0.9 g 氯化钠溶解在 100 mL ddH₂O中，得到澄清溶液。

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配方 3 中的溶解度: ≥ 2.08 mg/mL (3.59 mM) (饱和度未知) in 10% DMSO + 90% (20% SBE-β-CD in Saline) (这些助溶剂从左到右依次添加，逐一添加), 澄清溶液。
例如，若需制备1 mL的工作液，可将 100 μL 20.8 mg/mL澄清DMSO储备液加入900 μL 20% SBE-β-CD生理盐水溶液中，混匀。
*20% SBE-β-CD 生理盐水溶液的制备（4°C，1 周）：将 2 g SBE-β-CD 溶解于 10 mL 生理盐水中，得到澄清溶液。

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请根据您的实验动物和给药方式选择适当的溶解配方/方案：
1、请先配制澄清的储备液(如：用DMSO配置50 或 100 mg/mL母液(储备液));
2、取适量母液，按从左到右的顺序依次添加助溶剂，澄清后再加入下一助溶剂。以 下列配方为例说明 (注意此配方只用于说明，并不一定代表此产品 的实际溶解配方):
10% DMSO → 40% PEG300 → 5% Tween-80 → 45% ddH2O (或 saline);
假设最终工作液的体积为 1 mL, 浓度为5 mg/mL: 取 100 μL 50 mg/mL 的澄清 DMSO 储备液加到 400 μL PEG300 中，混合均匀/澄清；向上述体系中加入50 μL Tween-80，混合均匀/澄清；然后继续加入450 μL ddH2O (或 saline)定容至 1 mL；
3、溶剂前显示的百分比是指该溶剂在最终溶液/工作液中的体积所占比例;
4、 如产品在配制过程中出现沉淀/析出，可通过加热(≤50℃)或超声的方式助溶;
5、为保证最佳实验结果，工作液请现配现用！
6、如不确定怎么将母液配置成体内动物实验的工作液，请查看说明书或联系我们;
7、 以上所有助溶剂都可在 Invivochem.cn网站购买。