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L9-NC is an aerosolized liposomal formulation of 9-nitro-20(S)-camptothecin (rubitecan), a semi-synthetic derivative of the plant alkaloid camptothecin. Developed primarily by the M.D. Anderson Cancer Center, it functions as a DNA topoisomerase I inhibitor. By stabilizing the cleavable complex between DNA and topoisomerase I, it induces site-specific DNA double-strand breaks during the S-phase of the cell cycle, leading to apoptosis. The liposomal encapsulation is designed to facilitate delivery via inhalation, allowing for high local concentrations of the drug in the lungs while minimizing systemic exposure and toxicity. It has been investigated for the treatment of Ewing's sarcoma and other solid tumors with pulmonary metastases, often in combination with other agents like temozolomide.
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