Some of most important anti-cancer drugs are products of microbial fermentation. Anthracycline antibiotics, doxorubicin and daunorubicin, are widely used in treating solid tumours and haematological malignancies respectively. Recently, liposomal formulations have entered clinical practice. Epirubicin was developed as a less cardiotoxic analogue of doxorubicin. Idarubicin is an analogue of daunorubicin with increased activity in AML and the only anthracycline that can be given orally. Mitoxantrone is the most important of anthracenediones, a group of compounds structurally related to the anthracyclines. Two other structurally distinct anti-tumour antibiotics are in use:
♦ Actinomycin D, active in childhood tumours.
♦ Mitomycin C, used both as a cytotoxic and a radiosensitizer.
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