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Sagopilone is a fully synthetic small molecule belonging to the epothilone class, structurally related to patupilone and epothilone B. It acts as a microtubule-stabilizing agent by binding to tubulin, promoting microtubule polymerization, and inhibiting cell division—mechanistically similar to taxanes but with reduced susceptibility to multidrug resistance. Sagopilone demonstrated potent antiproliferative activity in various cancer cell lines, including those resistant to paclitaxel. It was investigated for several cancers such as ovarian cancer, breast cancer, non-small cell lung cancer (NSCLC), prostate cancer, glioblastoma, melanoma, and other neoplasms. The drug was able to cross the blood-brain barrier and showed clinical activity in some tumor types; however, its development was discontinued due primarily to adverse effects like peripheral neuropathy.
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