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Exatecan is a hexacyclic, water-soluble topoisomerase I inhibitor that is a structural analog of camptothecin with antineoplastic activity. It functions by preventing the religation of DNA strands during cell division, which leads to DNA damage and ultimately cell death. This makes it particularly effective against rapidly dividing cells, such as cancer cells. Exatecan has been investigated for multiple cancer indications including pancreatic cancer, lung cancer, sarcoma, leukemia, and others. More recently, it has been incorporated into antibody-drug conjugate (ADC) technology to improve targeted delivery.
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