Topoisomerase II inhibitor
- Stabilizes topoisomerase-II–DNA cleavage complexes → double-strand breaks
- Kills dividing tumor cells
- Secondary leukemia
- Myelosuppression
- Anthracycline cardiotoxicity is cumulative and dose-limiting
Drugs with this mechanism (3)
- Dexrazoxane — Iron-chelating cardioprotectant for anthracyclines; a separate use rescues anthracycline extravasation.
- Doxorubicin — Anthracycline with cumulative, largely irreversible cardiotoxicity.
- Etoposide — Topoisomerase II inhibitor; central to curative testicular regimens.
Self-check
- Which type of DNA break follows stabilized topoisomerase-II cleavage complexes?
Double-strand breaks. - Which later malignancy can follow topoisomerase-II inhibition?
Secondary leukemia.
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