Academic literature on the topic 'Vinblastine, vincristine, vinca alkaloids'
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Journal articles on the topic "Vinblastine, vincristine, vinca alkaloids"
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Vishesh Verma, Shivam Sharma, Kritika Gaur, and Nitin Kumar. "Role of vinca alkaloids and their derivatives in cancer therapy." World Journal of Advanced Research and Reviews 16, no. 3 (December 30, 2022): 794–800. http://dx.doi.org/10.30574/wjarr.2022.16.3.1378.
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Vinca alkaloids and its derivatives like Vincristine, Vinblastine etc. isolated from Catharanthus roseus plants are widely used in the treatment of various types of cancers. Mode of action of Vinca alkaloids (vinblastine, vincristine, vinorelbine) is microtubule-stabilizing agents (MTAs) i.e., arrest the cell cycle via disrupting microtubule dynamics. Vincristine major side effect is neurotoxicity. Hoverer, Vincristine induce neuropathy in mice or rat, used as animal model to study effect of drugs or plants by various authors also reported in review literature. Vinca alkaloids and its derivatives were widely used drugs in combination regimens with cyclophosphamide, doxorubicin, procarbazine, Methotrexate and dacarbazine etc. in various types of cancer. In this review, we also discussed major structure modifications position of chemically synthesized vincristine and vinblastine derivatives required for potential anticancer activities. Anticancer mechanism and some major patents on vinca alkaloids derivatives also reported in this review article. The study of Vinca alkaloids and its derivatives a class of an antimitotic compounds, found essential role in anticancer therapies.
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Montag, Gracia, Helga Stopper, Quoc Anh Ngo, and Henning Hintzsche. "The Biological Activity of the Novel Vinca Alkaloids 4-chlorochablastine and 4-chlorochacristine." Current Cancer Drug Targets 19, no. 3 (February 14, 2019): 222–30. http://dx.doi.org/10.2174/1568009618666180430142233.
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Background: Vinca alkaloids are important cancer drugs belonging to the class of antimitotic agents. The most commonly used substances are vinblastine and vincristine, other compounds are vinorelbine and vinflunine. All of them are very effective drugs but their use is limited by severe side-effects including neurotoxicity and bone marrow depression. Therefore, it is very important to develop novel vinca alkaloids with similar efficacy but lower toxicity. </P><P> Methods: Here, we analyzed two new compounds, 4-chlorochablastine and 4-chlorochacristine, with regard to their biological activity. These novel compounds were applied to a leukemia cell line at clinically relevant concentrations. For comparison, the established vinca alkaloids vinblastine, vincristine, vinorelbine, and vinflunine were also tested. </P><P> Results: Both novel substances decreased cellular proliferation. Apoptosis was found to be increased using two different methods reflecting early and late apoptosis. Cell cycle analysis revealed a clear decrease in G1-cells and an increase in G2/M-cells indicating an arrest in mitosis. In general, 4- chlorochablastine and 4-chlorochacristine caused these effects at concentrations higher than those needed for vinblastine, vincristine, and vinorelbine, but the potency was approximately in the range of vinflunine. </P><P> Conclusion: Taken together, the results show first indications that these novel vinca alkaloids might be effective and that they warrant further analysis.
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Huang, Yi, Yong Fang, Jinmin Wu, Jennifer M. Dziadyk, Xueming Zhu, Meihua Sui, and Weimin Fan. "Regulation of Vinca alkaloid-induced apoptosis by NF-κB/IκB pathway in human tumor cells." Molecular Cancer Therapeutics 3, no. 3 (March 1, 2004): 271–77. http://dx.doi.org/10.1158/1535-7163.271.3.3.
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Abstract Antimicrotubule Vinca alkaloids, such as vinblastine and vincristine, interfere with the dynamics of microtubules and have shown significant cell killing activity in a variety of tumor cells through induction of apoptosis. The mechanism by which Vinca alkaloids induce apoptosis is not entirely clear. In this study, we found that glucocorticoids inhibit Vinca alkaloid-induced apoptosis without affecting G2-M arrest in human breast cancer BCap37 cells and human epidermoid tumor KB cells, suggesting that Vinca alkaloid-induced apoptosis may occur via a pathway independent of cell cycle arrest. Further analyses indicated that Vinca alkaloids cause significant degradation of IκBα, which in turn results in nuclear factor-κB (NF-κB) activation. Transfection of antisense IκBα in BCap37 cells sensitizes Vinca alkaloid-induced apoptosis. Moreover, in vitro kinase assays show that the activity of IκB kinase (IKK) was activated by Vinca alkaloids and was not affected by glucocorticoids. Stable transfection of dominant-negative deletional mutant IκBα, which is insensitive to IKK-mediated phosphorylation and degradation, resulted in the inhibition of Vinca alkaloid-induced NF-κB activation and reduced sensitivity of tumor cells to Vinca alkaloid-induced apoptosis. These findings suggest that the NF-κB/IκB signaling pathway may contribute to the mediation of Vinca alkaloid-induced apoptosis in human tumor cells.
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Nithyanandham Masilamani and Dhanraj Ganapathy. "Awareness of Vinca alkaloids among dental students." International Journal of Research in Pharmaceutical Sciences 11, SPL3 (September 18, 2020): 911–14. http://dx.doi.org/10.26452/ijrps.v11ispl3.3048.
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Vincristine along with vinblastine are dual indole-based conjugated Vinca alkaloids formed from foliage of the herb Catharanthusroseus, traditionally known as Vincarosea vincristine , that have been effectively prescribed as single treatment and also in conjunction with other medications in hematological and stable malignancies chemotherapy for tumors. The purpose of this survey was to assess awareness of medical use of vinca alkaloids among dental undergraduate students. A cross-section study was performed with a self-directed survey questionnaire containing 10 queries distributed among 100 dental students. The questionnaire assessed the awareness about vinca alkaloids, their medicinal uses, anticancer activity, mechanism of action and side effects. The responses were recorded and analysed.94% of the respondents were not aware of medical uses of vinca alkaloids.95% were not aware of anticancer activity of vinca alkaloids.97 % were not aware of the mechanisms of action of vinca alkaloids. Again 97% were not aware of side effects of the vinca alkaloids. This study concluded the awareness about the medical use of vinca alkaloids among dental students was poor. Majority of them are not aware of the anticancer activity of vinca alkaloids.
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Mayer, Szabolcs, Péter Keglevich, András Keglevich, and László Hazai. "New Anticancer Vinca Alkaloids in the Last Decade - A Mini-Review." Current Organic Chemistry 25, no. 10 (June 1, 2021): 1224–34. http://dx.doi.org/10.2174/1385272825666210216123256.
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The chemistry and pharmacology of the important Vinca alkaloids such as vinblastine and vincristine used in anticancer therapy are still investigated widely. Several new derivatives, e.g., vinflunine, vinorelbine, and vindesine, have been synthesized and become successful medicines in anti-cancer therapy. In 2012, we published a paper that reviewed the Vinca derivatives. Nevertheless, the interest in the preparation of new modified structures is not decreasing either in recent years. In this review, the vinblastine-type molecules with several substituents, e.g., amide, nitrile, hydrazide, substituted side chains, etc. in different positions of catharanthine and/or vindoline cores are presented. An important part of the review is the derivatization of the monomer alkaloid vindoline, which possesses no antitumor effect. Additionally, new hybrid molecules of these alkaloids are also discussed in this mini-review.
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Sharma, Mukesh Kumar, Mohan Kumar, and Renu. "Biosynthesis and Modulation of Terpenoid Indole Alkaloids in Catharanthus roseus: A Review of Targeting Genes and Secondary Metabolites." Journal of Pure and Applied Microbiology 15, no. 4 (October 15, 2021): 1745–58. http://dx.doi.org/10.22207/jpam.15.4.05.
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The medicinal plant C. roseus synthesizes biologically active alkaloids via the terpenoid indole alkaloid (TIAs) biosynthetic pathway. Most of these alkaloids have high therapeutic value, such as vinblastine and vincristine. Plant signaling components, plant hormones, precursors, growth hormones, prenylated proteins, and transcriptomic factors regulate the complex networks of TIA biosynthesis. For many years, researchers have been evaluating the scientific value of the TIA biosynthetic pathway and its potential in commercial applications for market opportunities. Metabolic engineering has revealed the major blocks in metabolic pathways regulated at the molecular level, unknown structures, metabolites, genes, enzyme expression, and regulatory genes. Conceptually, this information is necessary to create transgenic plants and microorganisms for the commercial production of high-value dimer alkaloids, such as vinca alkaloids, vinblastine, and vincristine In this review, we present current knowledge of the regulatory mechanisms of these components in the C. roseus TIA pathway, from genes to metabolites.
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Noble, Robert L. "The discovery of the vinca alkaloids—chemotherapeutic agents against cancer." Biochemistry and Cell Biology 68, no. 12 (December 1, 1990): 1344–51. http://dx.doi.org/10.1139/o90-197.
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In folklore medicine, extracts of the leaves of the subtropical plant Catharanthus roseus (L.) G. Don (sometimes known as Madagascar periwinkle) were reputed to be useful in the treatment of diabetes. This review describes how attempts to verify the antidiabetic properties of the extracts led instead to the discovery and isolation of two complex indole alkaloids, vinblastine and vincristine, which are used in the clinical treatment of a variety of cancers. The two alkaloids, although structurally almost identical, nevertheless differ markedly in the type of tumors that they affect and in their toxic properties. These and related alkaloids have been the subject of many pharmacological and biochemical investigations both in vivo and in vitro in the search for improved cancer treatments. A model system used in these studies, a transplantable lymphoma in Noble strain rats designated Nb2 node, has serendipitously led to the development of a highly sensitive and specific bioassay for lactogenic hormones.Key words: Catharanthus roseus, vinblastine, vincristine, cancer chemotherapy, Nb rat lymphoma, lactogen bioassay.
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Agrawal, Vaibhav, Diane T. Smelser, David J. Carey, Joseph J. Vadakara, and Sharif S. Khan. "Effect of the CEP72 Genotype and CYP3A5-Mediated Metabolism in Predicting Vincristine-Associated Peripheral Neuropathy." Blood 128, no. 22 (December 2, 2016): 5963. http://dx.doi.org/10.1182/blood.v128.22.5963.5963.
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Abstract Introduction: Chemotherapy induced peripheral neuropathy (CIPN) is a recognized clinical outcome of vinca alkaloid based therapy that frequently results in dose reduction or therapy discontinuation, but the determinants of interpatient variability remain unpredictable. Previous pharmacogenetics studies have demonstrated that vincristine is metabolized through the CYP3A system with the CYP3A5*3 variant (GG allele at rs776746) having the least efficacy in metabolizing vincristine to its inactive metabolite M1 and conferring higher risk of neurotoxicity. Similarly, a single nucleotide polymorphism (SNP) in the promoter of the CEP72 gene (TT allele at rs924607) has been described as being significantly associated with increased risk and severity of vincristine-associated peripheral neuropathy in the pediatric population. Our recent studies have further studied the incidence of this risk allele and its correspondence with CIPN in the adult population treated with vincristine. This study aimed to investigate if an additive SNP analysis, both for CYP3A5*3 and CEP72, would determine increased predictability of CIPN in patients treated with vinca alkaloids. Methods: A retrospective case-control study of patients was completed in patients that were exposed to vinca alkaloids (vincristine, vinorelbine, and vinblastine) at Geisinger Medical Center from 2007-2015. Available samples of these patients were identified in the Geisinger MyCode bio banking project and the SNP of interest was genotyped using the TaqMan® SNP Genotyping Assay, with genotypic discrimination performed using SDS software (Applied Biosystems). Cases of CIPN were confirmed with retrospective chart review. Statistical analysis was conducted using SAS (SAS Institute Inc.) software, version 9.4. All genotyping and chart review was conducted by personnel blinded to sample identity. Results: A total of 121 patients had genotype mapping completed, of which 60 patients received vincristine, 33 received vinblastine, and 28 received vinorelbine. CIPN was detected in 35.5% of the study population. The CEP72 risk allele (TT) was detected in 14.9% (n=18) of the cohort and the CYP3A5*3 risk allele (GG) was detected in 89.2% (n=108) of the cohort, with similar incidence in each drug class. The median age of this population was 61 years of age with 52.9% (n=64) being males. Multivariate logistic regression analysis, controlling for age and sex, did not demonstrate a significant model for the recessive genetic model of both SNPs with all vinca alkaloids (p=0.33), vincristine alone (p=0.26), vinorelbine alone (p=0.98), or vinblastine alone (p=0.97). The incidence of the inactive G/G allele for CYP3A5*3 was seen in 87.5% (n=21) of the vincristine cohort with neuropathy, The incidence of neuropathy was higher in patients with the TT genotype (75%) in patients receiving vincristine therapy than with the CT or CC genotype (35.7%). As consistent with prior findings, a similar dominant effect was not detected in vinorelbine or vinblastine groups. In the vincristine population (n=60), diseases that were treated included diffuse large B-cell lymphoma (n=29), acute lymphoblastic leukemia (n=6), oligoastrocytoma (n=5), and Ewing's sarcoma (n=2). No disease specific variation in neuropathy incidence and association with TT genotype was detected. Patients received a median three doses of vincristine at 2 mg each (total 6 mg) before detection of CIPN. Four patients (6.67%) of the patients required dose adjustment of chemotherapy, including dose reduction (n=2) or early discontinuation (n=2). Conclusions: This study demonstrates that the CEP72 genotype confers predictive modeling for patients receiving vincristine-based therapy and that including CYP3A5*3 analysis in an additive model is not associated with an increased predictive model for CIPN in patients receiving vinca alkaloid based therapy. In our population, the high incidence of the inactive G/G allele of CYP3A5*3 made it difficult to discern a significant effect in patients that experienced neuropathy. Larger studies are needed to include a more diverse population to confirm this predictive association and to understand if this can help guide precision-based chemotherapy administration and favorably impact disease prognosis. Disclosures No relevant conflicts of interest to declare.
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Keglevich, András, Szabolcs Mayer, Réka Pápai, Áron Szigetvári, Zsuzsanna Sánta, Miklós Dékány, Csaba Szántay, Péter Keglevich, and László Hazai. "Attempted Synthesis of Vinca Alkaloids Condensed with Three-Membered Rings." Molecules 23, no. 10 (October 9, 2018): 2574. http://dx.doi.org/10.3390/molecules23102574.
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Our successful work for the synthesis of cyclopropanated vinblastine and its derivatives by the Simmons–Smith reaction was followed to build up further three-membered rings into the 14,15-position of the vindoline part of the dimer alkaloid. Halogenated 14,15-cyclopropanovindoline was prepared by reactions with iodoform and bromoform, respectively, in the presence of diethylzinc. Reactions of dichlorocarbene with vindoline resulted in the 10-formyl derivative. Unexpectedly, in the case of the dimer alkaloids vinblastine and vincristine, the rearranged products containing an oxirane ring in the catharanthine part were isolated from the reactions. The attempted epoxidation of vindoline and catharanthine also led to anomalous rearranged products. In the epoxidation reaction of vindoline, an o-quinonoid derivative was obtained, in the course of the epoxidation of catharanthine, a hydroxyindolenine type product and a spiro derivative formed by ring contraction reaction, were isolated. The coupling reaction of vindoline and the spiro derivative obtained in the epoxidation of catharanthine did not result in a bisindole alkaloid. Instead, two surprising vindoline trimers were discovered and characterized by NMR spectroscopy and mass spectrometry.
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Mayer, Szabolcs, András Keglevich, Csilla Sepsey Für, Hedvig Bölcskei, Viktor Ilkei, Péter Keglevich, and László Hazai. "Results in Chemistry of Natural Organic Compounds. Synthesis of New Anticancer Vinca Alkaloids and Flavone Alkaloids." Chemistry 2, no. 3 (August 10, 2020): 714–26. http://dx.doi.org/10.3390/chemistry2030046.
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The antitumor indole–indoline alkaloids of the evergreen Catharanthus roseus—namely vinblastine and vincristine—are widely used in chemotherapy of cancer. Many efforts were made to synthesize more efficient derivatives with less side-effect. The 14,15-cyclopropane derivative of vinblastine was synthesized successfully by a five-step procedure starting from vindoline. Vincristine, vinorelbine and several derivatives condensed with a cyclopropane ring were synthesized. Various hybrid molecules were prepared by the coupling reaction of vindoline and methyl ester of tryptophan, which were conjugated by carrier peptides of octaarginine. Studying the halogenation reactions of vindoline and catharanthine some fluorine derivatives were obtained which showed promising antitumor activity on various tumor types. The synthesis of the Aspidospermane alkaloid bannucine and 5′-epibannucine were carried out using N-acyliminium intermediates. The same intermediate was also applied in the first synthesis of sessiline. The research group have synthesized of flavonoid alkaloids: dracocephins A and B. Further three flavonoid alkaloids, namely 8-(2”-pyrrolidinon-5′′-yl)quercetin, 6-(2′′-pyrrolidinon-5′′-yl)-(−)- and 8-(2′′-pyrrolidinon-5′′-yl)-(−)-epicatechin were prepared by acid-catalyzed regioselective Mannich reaction starting from the corresponding flavonoid precursor. Vindoline was also coupled to synthetic pharmacophores, such as triphenylphosphine and various N-heterocycles. Some of these hybrid molecules showed significant antitumor activity. Furthermore, 7-OH and 7-NH modified flavonoid derivatives were synthesized by a regioselective alkylation followed by Smiles rearrangement and hydrolysis.
Dissertations / Theses on the topic "Vinblastine, vincristine, vinca alkaloids"
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Zhou, Xiao-Jian. "Contribution a l'etude pharmacocinetique et metabolique des vinca alcaloides." Aix-Marseille 2, 1992. http://www.theses.fr/1992AIX22951.
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Gherbovet, Olga. "Synthèse d'hybrides vinblastine-phomopsine." Phd thesis, Université Paris Sud - Paris XI, 2013. http://tel.archives-ouvertes.fr/tel-00925057.
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La tubuline est une protéine essentielle de la cellule. En polymérisant sous forme de microtubules, elle crée notamment le fuseau mitotique le long duquel migrent les chromosomes pendant la mitose. Les médicaments qui inhibent la polymérisation et/ou la dépolymérisation de la tubuline sont des composés majeurs de la thérapie anticancéreuse. Les vinca-alcaloïdes en sont des représentants importants. Ils induisent la mort des cellules par apoptose, en inhibant la dynamique des microtubules. D'autres molécules d'origine naturelle, comme la phomopsine A, se fixent sur la tubuline à proximité ou dans le même site de fixation que celui des vinca-alcaloïdes. C'est la raison pour laquelle nous avons envisagé d'élaborer des composés antimitotiques hybrides entre la vinblastine et la phomopsine A. Dans ce contexte, deux séries de composés ont été conçues. La première série d'hybrides correspondant à des dérivés de l'anhydrovinblastine fonctionnalisés en position 7'. Cependant, aucune des trois stratégies étudiées n'a permis d'accéder à ces composés. La deuxième série d'hybrides, dérivés de la 7'-homo-anhydrovinblastine a pu être synthétisée grâce à une réaction originale d'insertion d'acétylènes activés au niveau du pont gramine de la vinorelbine, suivie d'une réduction avec un contrôle totale de la régio- et stéréoselectivité. Dans un premier temps, les réactions d'insertion et de réduction ont été mise au point. Ensuite, deux familles d'hybrides portant la chaîne latérale de l'octahydrophomopsine en position 8' ou 7' ont été synthétisés. La plupart des composés ainsi obtenus possédent une excellente activité sur la tubuline et sont très cytotoxique.
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Harvey, Michael John. "Towards the Assembly of the Binary Vinca Alkaloids: Strategies for the Synthesis of Analogues of the Indole-Indoline Core of (+)- Vinblastine." Phd thesis, 2006. http://hdl.handle.net/1885/49421.
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The clinically important alkaloids (+)-vinblastine (1) and (+)-vincristine (2) both exhibit extraordinary potency as anti-mitotic agents and act by destabilising polymerised tubulin. While the development of a structure-activity-relationship (SAR) profile around these natural products should allow for the identification of the relevant pharmacophore, this task is especially daunting because of the structural complexity of these compounds. Indeed, most analogues of the Vinca alkaloids are obtained through modifications of the natural products rather than being generated de novo by “total synthesis”...
Book chapters on the topic "Vinblastine, vincristine, vinca alkaloids"
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Talapatra, Sunil Kumar, and Bani Talapatra. "Dimeric Indole Alkaloids. Vinblastine (Vincaleukoblastine), Vincristine (Leurocristine), and Their Derivatives." In Chemistry of Plant Natural Products, 901–7. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-45410-3_28.
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Kaur, Jagjit, Apoorva Singh, Teena Pathak, and Kuldeep Kumar. "Role of PGRs in Anticancer Alkaloids (Vincristine and Vinblastine) Production." In Catharanthus roseus, 309–19. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-51620-2_12.
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Alam, M. Masidur, M. Naeem, M. Masroor A. Khan, and Moin Uddin. "Vincristine and Vinblastine Anticancer Catharanthus Alkaloids: Pharmacological Applications and Strategies for Yield Improvement." In Catharanthus roseus, 277–307. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-51620-2_11.
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ATTA-UR-RAHMAN, ZAHIDA IQBAL, and HABIB NASIR. "Synthetic Approaches to Vinblastine and Vincristine - Anticancer Alkaloids of Catharanthus Roseus." In Stereoselective Synthesis (Part I) - Studies in Natural Products Chemistry, 805–77. Elsevier, 1994. http://dx.doi.org/10.1016/b978-0-444-81780-8.50028-4.
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Taber, Douglass F. "The Boger Synthesis of (-)-Vindoline." In Organic Synthesis. Oxford University Press, 2013. http://dx.doi.org/10.1093/oso/9780199965724.003.0096.
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The periwinkle-derived alkaloids vinblastine 2a and vincristine 2b are still mainstays of cancer chemotherapy. The more complex half of these dimeric alkaloids, vindoline 1, presents a formidable challenge for total synthesis. Building on his previous work (Organic Lett. 2005, 7, 4539), Dale L. Boger of Scripps/La Jolla devised (J. Am. Chem. Soc. 2010, 132, 3685) a strikingly simple solution to this problem based on sequential cycloaddition. The starting point for the synthesis was the ester 3, derived from D-asparagine. This was extended to 4, condensation of which with 5 gave the enol ether 6. On heating, 7 cyclized to 8, which lost N2 to give the zwitterion 9. Addition of the intermediate 9 to the indole then gave 10. In one reaction, the entire ring system of vindoline, appropriately oxygenated, was assembled, with the original stereogenic center from D-asparagine directing the relative and absolute configuration of the final product. To complete the synthesis, the pendant carbon on 11 had to be incorporated into the pentacyclic skeleton. After adjusting the relative configuration of the secondary alcohol, the N was rendered nucleophilic by reduction of the amide to the amine. Oxidation delivered 14, which on activation as the tosylate smoothly rearranged to the ketone 15. Reduction and regioselective dehydration then completed the synthesis of vindoline 1.
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Li, Jie Jack. "Imatinib Mesylate (Gleevec)." In Top Drugs. Oxford University Press, 2015. http://dx.doi.org/10.1093/oso/9780199362585.003.0010.
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Great strides had been made in the war against cancer with chemotherapy even before the emergence of protein kinase inhibitors. For instance, prior to vinblastine (1, Velban) became available in 1964 for the treatment of lymphoma, the diagnosis of Hodgkin’s disease (a cancer of the lymph nodes) was virtually a death sentence. Today there is a 90% chance of survival with the treatment by vinca alkaloids such as 1 and other chemotherapies. Similarly, when Sidney Farber discovered the effects of methotrexate (2, Trexall) on leukemia, it marked the beginning of the triumph over childhood leukemia. Following Barnett Rosenberg’s discovery of cisplatin (3, Platinol)’s effects on tumor cells in 1967, cisplatin and its analogs such as carboplatin (4, Paraplatin) and oxaliplatin (5, Eloxatin) contributed significantly in boosting the survival rate of patients with metastatic testicular cancer, ovarian tumors, and bladder cancer. Most significantly, breast cancer, a malady striking one in eight women, has been effectively managed via a plethora of treatments including surgery, radiation, and chemotherapies. The arsenal of chemotherapeutics for treating breast cancer includes SERMs such as tamoxifen (6) and raloxifene (7, Evista). Type I, II, and III aromatase inhibitors have now also been widely prescribed to combat breast cancers (more details may be found in chap. 4). Today, breast cancer is sometimes viewed as a chronic disease that can be managed, rather than a lethal disease. Despite the efficacy of the aforementioned chemotherapeutics, they kill cancer cells and normal cells with equal ferocity. (Some have compared chemotherapy to a “carpet bombing” strategy.) However, the reason these chemotherapies are effective is that cancer cells divide at much faster rate than normal cells; therefore, chemotherapies kill more malignant cells than healthy cells. Chemotherapies invariably come with significant side effects rooted. For example, hair follicle cells have a physiologically high mitosis rate; therefore, chemotherapies kill them faster than other healthy cells. In the same vein, other common side effects of chemotherapy include diarrhea (because ephithelial renewal is inhibited), bone marrow suppression (because granulopoiesis, thrombopoiesis, cytopoiesis, and erythropoiesis are inhibited), and lymph node damage (because of lymphocyte multiplication inhibition causes immune weakness).