Mitoxantrone (Novantrone) is a synthetic anthraquinone that is structurally and mechanistically related to the an-thracyclines. It intercalates with DNA and produces single-strand DNA breakage. It is cross-resistant with dox-

orubicin in multidrug-resistant cells and in patients who have failed to respond to doxorubicin therapy.

Mitoxantrone is active against breast carcinomas, leukemias, and lymphomas. Its antitumor efficacy in patients with breast cancer is slightly lower than that of doxorubicin. Its major toxicity is myelosuppression; mu-cositis and diarrhea also may occur. Mitoxantrone produces less nausea, alopecia, and cardiac toxicity than does doxorubicin.

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