Vosaroxin : a novel antineoplastic quinolone.

INTRODUCTION: The antineoplastic quinolone derivative vosaroxin (SNS-595, Sunesis, South San Francisco, CA, USA) was first described in 2002. It represents a novel class of anticancer drugs and is currently in a Phase III clinical trial for relapsed and refractory acute myeloid leukemia (AML). AML is the most common form of acute leukemia in adults and is increasing in incidence due to the aging of the American population. Despite advances in diagnosis, prognostic prediction, and treatment in younger age groups, there has been little improvement in survival among patients over 60 years of age, who make up the majority of those affected. AREAS COVERED: The development of vosaroxin, its mechanism of action, pharmacology, and metabolism, and the preclinical and clinical data to date will be covered. EXPERT OPINION: Despite its structural dissimilarity, vosaroxin has mechanisms of action similar to the anthracyclines and anthracenediones already in use for the treatment of AML. However, unlike these agents, vosaroxin is not a P-gp substrate, appears to be unaffected by overexpression of P-gp or TP53 mutations, and may be useful in the treatment of AML, especially in the elderly.