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Afeletecan is a water-soluble camptothecin derivative conjugated to a carbohydrate moiety exhibiting antineoplastic activity. It functions by stabilizing the topoisomerase I-DNA covalent complex, which inhibits both the initial cleavage reaction and religation steps. This leads to the inhibition of DNA replication, double-strand DNA breakage, and ultimately triggers apoptosis. The carbohydrate moiety is designed to stabilize the lactone form of camptothecin in the blood. It is classified as a small molecule drug.
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