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Belotecan is a semi-synthetic camptothecin analogue and small molecule antineoplastic agent. It acts as a topoisomerase I inhibitor, stabilizing the cleavable complex of topoisomerase I-DNA, which prevents religation of single-stranded DNA breaks during DNA replication. This leads to lethal double-stranded DNA breaks when encountered by the replication machinery, resulting in disruption of DNA synthesis and apoptosis in tumor cells. Belotecan is primarily indicated for small-cell lung cancer (SCLC) and ovarian cancer, with approval in South Korea under the trade name Camtobell since 2003. It has also been investigated for other cancers such as cervical cancer and non-small cell lung cancer[2][3][4][6].
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