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Banoxantrone is a highly selective bioreductive small molecule prodrug developed for cancer therapy. It is preferentially activated in hypoxic tumor cells by cytochrome P450 enzymes, converting to its cytotoxic form, AQ4. This active metabolite intercalates into and crosslinks DNA and inhibits topoisomerase II, leading to inhibition of DNA replication and repair in tumor cells. Banoxantrone displays little cytotoxicity under normoxic conditions but becomes highly toxic to hypoxic tumor regions, making it synergistic with radiotherapy or chemotherapy that targets oxygenated cells. The drug was investigated primarily for various cancers including glioblastoma multiforme, chronic lymphocytic leukemia, non-Hodgkin lymphoma, acute lymphoblastic leukemia, and advanced solid tumors[1][2][3][4][5][9].
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