Catalytic inhibitors of mammalian
DNA topoisomerase II have been found recently in natural and synthetic compounds. These compounds target the
enzyme within the cell and inhibit various genetic processes involving the
enzyme, such as DNA replication and chromosome dynamics, and thus proved to be good probes for the functional analyses of the
enzyme in a variety of eukaryotes from yeast to mammals. Catalytic inhibitors were shown to be antagonists against
topoisomerase II poisons. Thus bis(2,6-dioxopiperazines) have a potential to overcome
cardiac toxicity caused by potent antitumor
anthracycline antibiotics such as
doxorubicin and
daunorubicin.
ICRF-187, a (+)-enantiomer of racemic
ICRF-159, has been used in clinics in European countries as cardioprotector. Furthermore, bis(2,6-dioxopiperazines) enhance the efficacy of
topoisomerase II poisons by reducing their side effects in preclinical and clinical settings. Bis(2,6-dioxopiperazines) per se among others have antitumor activity, and one of their derivatives,
MST-16 or
Sobuzoxane, bis(N1-isobutyloxycarbonyloxymethyl-2, 6-dioxopiperazine), has been developed in Japan as an anticancer
drug used for
malignant lymphomas and
adult T-cell leukemia in clinics.