epirubicin + lonidamine

Epirubicin + lonidamine is a combination therapy consisting of the anthracycline chemotherapeutic agent epirubicin and the mitochondria-targeting small molecule lonidamine. Epirubicin acts primarily as a DNA intercalator and topoisomerase II inhibitor, leading to inhibition of DNA replication and cell death in rapidly dividing cancer cells. Lonidamine disrupts energy metabolism in tumor cells by inhibiting glycolysis and mitochondrial function, thereby sensitizing cancer cells to chemotherapy. This combination has been investigated primarily for advanced breast cancer, where clinical studies have shown that adding lonidamine to epirubicin increases response rates compared to epirubicin alone, particularly in patients with liver metastases. The regimen is generally well tolerated with moderate toxicity; myalgia is more common when both drugs are used together[2][4].