Key Heterocyclic Cores for Smart Anticancer Drug–Design Part II E-Book
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- Herausgeber: Bentham Science Publishers
- Kategorie: Fachliteratur
- Sprache: Englisch
This book provides an update on heterocyclic compounds that serve as key components of anti-cancer agents administered in pre-clinical settings. Many of the compounds highlighted in the book are being actively investigated for the bioactive properties against a range of cancer cell lines. There is potential for heterocyclic compounds to design agents that can target specific molecules to treat different types of cancers. Chapters are contributed by experts in pharmaceutical chemistry and are written to give a general overview of the topic to readers involved in all levels of research and decision-making in pharmaceutical chemistry and anti-cancer drug design.
Part 2 of the book set covers these topics:
- Anticancer targets for heterocyclic lead compounds
- Coumarin hybrids for cancer treatments
- Progress in nitrogen and sulphur-based heterocyclic compounds for their anticancer activity
- Imidazole as an anticancer heterocyclic ring
- Morpholine for profiling anticancer lead compounds
- Natural products as anticancer agents
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Seitenzahl: 336
Veröffentlichungsjahr: 2002
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FOREWORD
In the age of knowledge and technology, cancer is a disgrace on the face of humanity. Despite the fact that tremendous progress has been made in cancer therapy over the past 50 years, it remains a critical public health concern needing extensive research into new therapeutic strategies. Despite the availability of numerous anticancer drugs, issues such as multidrug resistance, diminished therapeutic efficacy, solubility, unwanted side effects, and poor bioavailability necessitate the development of novel anticancer therapies. Due to their exceptional pharmacological activity, specifically their anticancer properties, heterocyclic compounds have dominated medicinal chemistry for more than a century. Currently, the available chemical galaxy includes more than 100 million organic compounds, mainly related to a limited set of classes and types. At the same time, modern drug design trends require the development of synthetic approaches to equally and diversely fill the chemical space as a source of drug-like structures. These trends have affected heterocyclic chemistry as the main "supplier" of drug-like molecules (all top 10 brand name small molecule drugs contain heterocyclic moieties).
This book, which is named "Key Heterocyclic Cores for Smart Anticancer Drug-Design- Part II," offers a comprehensive analysis of several of the most interesting and contemporary hot topics in the research and development of cutting-edge cancer chemotherapeutics. This book is written with the intention of providing readers with a quick overview of the biological targets, structure-activity relationship (SAR), existing issues, and future prospects of heterocyclic-based anticancer drugs.
This book has piqued my interest tremendously, and I can't wait for it to be available in print as soon as possible. This book is useful as a resource for students, researchers, academicians, and medicinal chemists. The authors and Bentham publishers deserve praise for delivering timely and relevant information.
PREFACE
Cancer which takes millions of lives every year, has been a curse on humans for a long time. New cancer targets are the prime need for researchers worldwide to develop effective anticancer drugs. The heterocyclic compounds and typically prevalent heterocyclic fragments present in most clinical drugs are the foundation of anticancer drug discovery.
This second volume of the book series “Key Heterocyclic cores for Smart Anticancer Drug-Design-Part II” focuses on various green methodologies for the synthesis of these heterocyclic cores. Furthermore, different chapters provide insight into the structure-activity relationship (SAR) of heterocyclic cores to reveal different pharmacophores accountable for anticancer activity. The volume comprises 6 scholarly written review chapters by leading researchers in the field, covering a broad range of topics.
The basic metabolism and biochemical process in the human body leading to cancer can play a decisive role in identifying and revealing new anticancer drug targets. In the first chapter of this book, Shweta et al. reviewed the various biochemical modes of action, biological targets and futuristic development for these heterocyclic cores for treating various types of cancer. The novel targets are also illustrated with a pictorial presentation to understand heterocyclic drug action on various cancer targets.
The concept of molecular hybridization has opened new doors towards designing and developing therapeutic candidates capable of binding to multiple targets. In this direction, several research groups have explored the therapeutic potentials of coumarin and its derivatives against cancer. In chapter two, Rohit et al. contributed a comprehensive review on important targets and their significance in the development of cancer. A description of reported potent anticancer coumarin hybrids inhibiting/interacting with particular targets investigated in the last five years has been provided, along with their structure-activity relationship (SAR).
Researchers and scientists have paid much attention to the drug design, and drug discovery of nitrogen (N) and sulphur (S) based heterocyclic compounds in the last decade. These N and S-based heterocyclic compounds such as pyrrole, quinazoline, thiadiazole and quinoline are widely used in the rational drug design for anticancer drugs with a favourable therapeutic index. In Chapter 3, Koli and Singh have reviewed the SAR study of recent literatures (2016-2020) in which N and S heterocyclic compounds are present as the core structure in the molecule. This chapter also emphasized the benefits of hybrid heterocyclic molecules acting via multiple target mechanisms.
The search for new anticancer agents to fight against cancer is not an ending process. Keeping in view, the aromatic diazole heterocyclic nucleus named imidazole proved promising health benefits. The significant therapeutic potential of the imidazole derivatives has triggered the medicinal chemist to develop a large number of novel anticancer compounds with a low toxicity profile. Chapter 4 by Dhingra et al. critically assessed the imidazole, demonstrating its number of anticancer analogues synthesized by various synthetic procedures. In addition, the chapter also describes the available marketed drugs having an imidazole nucleus bearing distinct substituents.
Morpholine is a highly privileged and versatile heterocyclic ring in medicinal chemistry with various biological activities due to its distinct mechanistic pathways. The talent of the morpholine ring to modulate the pharmacokinetic properties of the compounds further motivated the researchers to exploit the morpholine ring as a vital pharmacophore in developing lead compounds. Chapter 5 by Kumari and Singh outlined various synthetic strategies of morpholine ring and morpholine derivatives as potent anticancer agents. The latest data on novel anticancer morpholine derivatives with structural-activity relationship (SAR) is elaborated. The chapter also highlighted the clinical data of morpholine derivatives with anticancer activity and mechanism of action.
Natural products have played a significant role in providing novel and effective treatment inputs in anticancer research. Natural products have been a source of many anticancer agents that are being used in clinical or pre-clinical trials. Further, many compounds derived from natural products have shown the potential to be future anticancer agents. Due to their actions on numerous targets, natural products are considered ideal for anticancer drug development. In Chapter 7, Chaudhary et al. discuss the progress and ongoing developments in natural products and their analogues as anticancer agents. The challenges and future prospects of natural-based anticancer agents are also discussed.
The editor wishes to express their considerable appreciation to all the contributors of the chapters for their hard and scholarly work. We are also grateful to Mr. Mahmood Alam (Director Publication) and Ms. Humaira Hashmi (Manager Publication) of Bentham Science Publisher, who took over the management of the production of this book during the difficult circumstances of the COVID pandemic; their contribution is much appreciated. We are confident that this book will be a compelling guide to facilitate researchers, pharmacologists, and medicinal chemists in understanding the mechanism of heterocyclic drugs, which can help develop new anticancer agents.
List of Contributors
Understanding Promising Anticancer Targets for Heterocyclic Leads: An Introduction
Shweta Sharma1,Mymoona Akhter1,Rajesh Kumar Singh2,*Abstract
With the second-highest cause of mortality in the world, cancer becomes a major threat around the globe. In the last few decades, heterocyclic compounds, obtained naturally or synthetically, have been developed as a potential scaffold for developing many anticancer drugs. Heterocyclic compounds due to heteroatoms such as oxygen, nitrogen and sulphur can be employed as hydrogen bond donors as well as acceptors. Thus, they can bind suitably to pharmacological targets and receptors via intermolecular H-bonds more effectively, giving pharmacological effects. They can also alter liposolubility, hence the aqueous solubility of drug molecules to achieve remarkable pharmacotherapeutic properties. These heterocyclic leads exert the anticancer activity by a distinctive mechanism such as inhibiting Bcl-2, Mcl-1 proteins (induce apoptosis), inhibiting PIM proteins (hinder the cellular process and signal transduction in cells), inhibiting DNA topoisomerase, inhibiting aromatase (inhibit replication and transcription), modulating epigenetic mechanisms (inhibit histone deacetylase/HDAC) and inhibiting cellular mitosis (tubulin inhibitors).The current chapter aims to describe these promising anticancer targets. The novel targets are also illustrated with a pictorial presentation to understand heterocyclic drugs action on various cancer targets. This chapter will facilitate researchers, pharmacologists, and medicinal chemists in the understanding mechanism of heterocyclic drugs, which can help develop new anticancer agents.
INTRODUCTION
Cancer is generally characterized by the uncontrolled growth rate of cells in any part of the body. According to recent studies presently, 9.6 million deaths out of
18.1 million new cases were reported in 2018 to publicize undivided attention to design potential leads for cancer therapy. To date, a total of 277 types of cancer have been observed, out of which small cell lung cancer leads the chart of mortality rate [1, 2].
Over the years, various heterocyclic compounds obtained either naturally or synthetically have been explored as potential scaffolds as anticancer agents. Thus, hunting for undiscovered classes of drug molecules against cancer cells captivated the attention of researchers globally. Therefore, unwrapping various cell-cycle regulators and apoptotic stimuli for cancer to dust up cancer cells seems an attractive strategy in developing potential anti-tumor agents.
In the present chapter, we aim to present an overview of different heterocyclic drugs acting on potentially known targeted proteins in a pictorial form to understand the mechanism of action better. In addition to this, novel targets have also been highlighted in the chapter.
VARIOUS HETEROCYCLIC ANTICANCER DRUG TARGETS
Heterocyclic drugs are the moieties in which one or more carbon atoms have been substituted by various hetero atoms (including oxygen, nitrogen, sulfur etc.) that form the backbone of the molecule [1]. Heterocycles are the basic fundamental ingredient of loads of the available anticancer agents on the market today. Almost two-thirds of anticancer agents, which were approved between 2010 and 2015, possess heterocyclic rings [3]. Therefore, we summarized various heterocyclic scaffolds reported for their anticancer potential against distinct targets pictorially to make readers understand their functioning easily.
HETEROCYCLIC DRUGS AS PROTEIN DEACETYLATION INHIBITORS
Histone Deacetylase (HDAC) Inhibitors
In the past few decades, HDAC emerged as a key drug target for the development of anticancer drugs. Histone Deacetylase inhibitors are also referred to as lysine deacetylase or deacetylase inhibitors [3]. They act exclusively not only against several types of HDACs (HDAC isoform-selective inhibitors) but also against all types of HDACs (pan-inhibitors). HDAC inhibitors can be categorized chemically into four classes of compounds: (a) hydroxamic acids; (b) short-chain fatty (aliphatic) acids; (c) benzamides; (d) cyclic tetrapeptides [4]. Various classes of HDAC inhibitors as heterocyclic drugs have been presented here in Fig. (1).
Fig. (1)) Structures and name of diverse heterocyclic scaffolds as HDAC inhibitors with their chemical classes.Mechanistically, HDAC inhibitors removed the acetyl group from lysine residue, which plays an important role in initiating and activating the cellular transcription process. Acetylation of lysine residues occurs post-transcriptionally on the NH3 group of lysine residue entrenched in the core of N-terminal tails resulting in the emergence of transcriptionally active chromatin, which is less compact in nature. Therefore, HDAC inhibitor halts this acetylation process by deacetylating, as mentioned above, thereby preventing hyperacetylation of histones and strongly alters the gene expression process and leads to cancer [5]. The pictorial contouring of the mechanism of action of HDAC inhibitors has been shown in Fig. (2) for better understanding.
Fig. (2)) Mechanism of action of HDAC inhibitors.Till date, four drugs viz., Vorniostat [6], Romidepsin [7], Belinostat [8], Panbiostat [9] have been approved as HDAC inhibitors. Vorinostat (suberanilo-hydroxamic acid, SAHA) is a hydroxamic acid derivative that got FDA approval in 2006, developed by Merck & Co. [6] interacts with the binding pocket of HDAC enzyme and performs a role of chelator for zinc ions which are present in the binding pocket of HDAC enzyme [10].
Vorinostat inhibits cancer in distinct ways with different combination therapy. First and foremost, it seems like a reliable option in CTCL and an efficacious radiosensitizer in human glioblastoma cell lines [11]. Moreover, in combination with temozolomide and radiotherapy, it was found effective against glioblastoma multiforme (GBM). Type I and Type II endometrial malignant cells also demonstrated their potential as a potent apoptotic and antiproliferative effect [12]. Furthermore, it inhibits cell growth, cyclin D1 and cyclin E expression, as well as p27 expression, histone acetylation, and apoptosis in both human and murine pulmonary cell lines [13]. Moreover, vorinostat, combined with capecitabine, resulted in the inhibition of in vivo growth of colorectal carcinoma in xenograft models [14]. Vorinostat has also shown its potential against gastrointestinal (GI) cancer [15]. Belinostat, another FDA approved hydroxamic acid derivative, is used therapeutically against relapsed or refractory PTCL [16]. It showed to be well tolerated in both groups, and it's activity was observed against Low Malignant Potential (LMP) cancer [17]. Furthermore, a phase II study in women with platinum-resistant Epithelial Ovarian Cancer (EOC) looked at the combination of belinostat and carboplatin. The three hepatocellular carcinoma cell lines (PLC/PRF/5, Hep3B, and HepG2) were also shown to inhibit cell growth and induce histone acetylation [18, 19].
Romidepsin, isolated from a culture of Chromobacterium violaceum by Fujisawa Pharmaceutical Company [20]. It is a prodrug, which is converted inside the cell after reduction of disulfide bond into thiol group, for the generation of an active form of the prodrug. It binds with the zinc atom located inside the Zn-dependent histone deacetylase pocket, thereupon inhibiting its activity [21, 22]. It also plays a role in preventing non-small cell lung cancer (NSCLC) cells from proliferating. When used in combination with bortezomib, it has been shown to inhibit A549 NSCLC cell growth by targeting histone acetylation and the expression of cell cycle and metalloproteinase proteins [23, 24]. It was also shown to destroy inflammatory breast cancer (IBC) emboli and improve lymphatic vascularization [25].
Sirtuin 1 Inhibitors
Sirtuin 1 (SIRT1) also emerged as a potential target for anticancer therapy. It is a nicotinamide adenosine dinucleotide (NAD)-dependent deacetylase which pulls out acetyl groups from different proteins [26]. There are seven types of sirtuins (SIRT 1 to SIRT 7), known presently in humans and found to be localized in distinct subcellular compartments. Sirtuins play a role in several biological processes, including transcriptional regulation, metabolic regulation, and cell survival [27].
Sirtuins activities can be regulated and used as a potential target in the treatment of neurodegeneration and cancer. As we are focusing on cancer so, these proteins undertake tumour-suppressing cellular activities by deacetylating proteins. It communicates with p53 and alleviates its functions by deacetylation process at the C-terminal of Lys382 residue of p53, thereby promoting tumour proliferation. Therefore, inhibition of SIRT1 leads to re-expression of Tumor Suppression Gene (TSG) and, in this way, helps in combating cancer [28]. According to some reports, it also possesses the prowess to deacetylate and nullify doubtless tumour-promoting transcription factors such as NF-ĸß and HIF-1α, which inhibits transcription activity, thus elevating TNF-α generated apoptosis [29]. A pictorial representation of the mechanism of action of SIRT1 inhibitors has been presented in Fig. (3).
Fig. (3)) Pictorial representation of mechanism of action of Sirtuin-1 inhibitors.Sirutin-1 inhibitors are broadly classified as:
Nicotinamide and its analogues: Nicotinamide, acridinedione, 1,4-dihydropyri- dineThioacyllysine-containing compounds: Thiourea, Thioamideβ-napthol containing inhibitors: Sirtinol, CambinolIndole derivatives: EX-527, AC-93252Suramin and its analogsAtenovin and its analogs: Tenovin 1, Tenovin-6Other sirtuin inhibitors: AGK2Nicotinamide, one of the primary sirtuin inhibitors discovered. It inhibits the SIRT1 enzyme. Nicotinamide and its analogues strike as efficacious in inhibiting the growth and viability of human prostate cancer cells [30, 31]. In the cell lines, A549 lung carcinoma and MCF-7 breast carcinoma, thioacyllysine-containing compounds had an antiproliferative effect [32]. Cambinol causes hyperacetylation of tubulin, p53, KU70, and FOXO3a in cellular studies and facilitates cell cycle arrest by inhibiting SIRT1 and/or SIRT2. In a mouse xenograft model, treatment of BCL6-expressing Burkitt lymphoma cells with cambinol induces apoptosis and decreases tumour growth [33]. In N-Myc transgenic mice, a preventative treatment with cambinol reduces the formation of neuroblastoma [34]. Cambinol inhibits SIRT1-mediated deacetylation and transcription activity of the estrogen-related receptor in human breast cancer cells, resulting in a significant reduction in aromatase (CYP19A1) levels [35]. Indole derivatives EX527 induced apoptosis in leukaemia cells when combined with HDAC inhibitors [36]; protected against oculopharyngeal muscular dystrophy while AC-93253 showed cytotoxic effects in prostate DU145, pancreas MiaPaCa, lung A549 and NCI-H460 cancer cell lines [37]. Structural representation of various heterocyclic moieties as SIRT1 inhibitors is shown in Fig. (4).
HETEROCYCLIC DRUGS AS INHIBITORS OF CELLULAR PROLIFERATION
Tubulin Inhibitors
Tubulin, a dimeric protein, possesses two sub-units α and β, which are non-identical in nature, constitutes a key structural component to form microtubules. These microtubules are cellular components found in the eukaryotic organism and control various biological activities like mitosis, intracellular transport, and motility [38]. Tubulin inhibitors bind with tubulin protein to prevent polymerization, thereby disrupting the assembly of mitotic spindles fibres and hamper cytoskeletal function, which failed to take up successor steps [39]. The mechanism of action of tubulin inhibitors has been depicted in Fig. (5).
According to different binding sites present on the microtubule, inhibitors can be categorized into three different classes: (a) taxane binding domain (b) vinca binding domain. (c) Colchicine binding domain
(a)Taxane binding domain: Taxane family includes known inhibitors like Paclitaxel, Docetaxel, and Epothilones. Paclitaxel is the first inhibitor from the taxane family used for cancer chemotherapy [40]. It is used widely in a range of solid tumours as a chemotherapeutic agent. Another drug, Decetaxel, also has the same effects as Paclitaxel, which targets the M-phase of the cell cycle, which is responsible for stabilizing microtubules, thus preventing disaggregation [41]. Therapy with Docetaxel showed survival rate benefits in patients with Castration-Resistant Prostate Cancer (CRPC) [42]. Moreover, the clubbing of Histone Deacetylase Inhibitors (HDACIS) with docetaxel is observed to show inhibition of cancer cell growth synergistically [43]. A newly developed anti-tumour drug, Epothilone, gives an added advantage over other reported taxanes as it is found effective in cells due to their ability to bind with β-tubulins I and III equally [44]. It showed potential lung cancer activity, breast cancer and prostate cancer with good therapeutic efficacy in hormone-refractory metastatic prostate cancer and taxane-refractory ovarian cancer [45].(b)Vinca binding domain: Several heterocyclic compounds like Vinfluinine, Vincristine, Vinorelbine, Dolastatin 10 have been categorized as Vinca binding domain as all of them binds to the vinca domain in microtubules [46]. Vinflunine represents vinca alkaloid approved as second-line drug therapy against urothelial advanced transitional cell carcinoma (TCCU) [47]. Vinflunine-gemcitabine and vinflunine-carboplatin combination sound to be the most reliable preferences for first-line chemotherapy against urothelial cancer [48]. In addition, the combined therapy of oxaliplatin and vinblastine can provoke cytogenetic damage and inhibit survivin expression [49]. Another vinca alkaloid, Vincristine, when given in combination with quercetin, was found more efficacious in treatment therapy of lymphoma through a co-delivery mechanism using nanocarriers [50]. It is highly toxic and causes neuropathy, as reported in Omani study [51].A semi-synthetic drug, Vinorelbine, blocks the polymerization of tubules, thereby inhibiting cell division in the middle stage of mitosis [52]. For stage IIIA patients with EGFR mutation-positive non-small-cell lung cancer (EVAN), a combination of Vinorelbin+Erlotinib+Cisplatin has been used as adjuvant treatment [53]. Dolastatin 10, another drug, is very effective against cytotoxic microtubules. Due to their robust in vitro activity and payload capacity for antibody-drug conjugates (ADC), natural synthetic analogues of dolastatin 10 have sparked a lot of interest [54]. According to studies, the 10-terminal thiazole moiety of dolastatin has functional group analogues, including amines, alcohols, and thiols, according to studies [55]. These new analogues have excellent titers in tumour cell proliferation assays. The combination of largazole and dolastatin 10 has been shown to inhibit the growth of HCT116 cancer cells, demonstrating a synergistic impact [56, 57].
A tricyclic alkaloid obtained from the colchicines binding domain possesses anti-inflammatory activity, which blocks activation of inflammatory bodies by inhibiting tubulin polymerization [58]. Furthermore, it interferes with distinct inflammatory pathways [59].
Fig. (4)) Structures and name of diverse heterocyclic scaffolds as SIRT-1 inhibitors with their chemical classes. Fig. (5)) Pictorial representation showing mechanism of action of Tubulin inhibitors.(c) Colchicine Binding Domain:
Podophyllotoxin, another colchicine domain binding agent, is an effective cytotoxic agent [60], though its efficacy is restricted due to its resistance and side effects. In addition, Noscapine, a phthalo-isoquinoline alkaloid employed as an antitussive medicine for many years and is highly safe [61]. Noscapine capacity to force the microtubules to enhance the paused state duration, subsequently block the mitosis, and induce mitotic slip or mitotic mutation apoptosis contributed toward its anticancerous effect. Noscapine selectively blocked NF-κB, a critical transcription factor in the pathogenesis of glioblastoma; thus, it inhibits tumour growth and improves tumour chemotherapy sensitivity [62]. It has shown low toxicity as compared to colchicine and podophyllotoxin. In neurodegenerative disease and stroke mouse models, it also has shown neuroprotective properties [63]. The combination of paclitaxel and nicardipine was found to increase the proportion of apoptotic cells in human prostate cancer cell lines LNCaP and PC-3, owing to its anti-tumour effects [63]. These results established a new foundation for the treatment of prostate cancer [64]. Chemical structure of inhibitors is presented in Fig. (6).
Fig. (6)) Structures and name of diverse heterocyclic scaffolds as Tubulin inhibitors with their chemical classes.Topoisomerase Expression Inhibitors
Topoisomerase II is an ATP dependent enzyme and possesses an ATP binding domain instead of the DNA binding domain. Topoisomerase II enzymes can knick/cut two DNA strands and seal the cut using ATP [65].
Mechanistically, inhibitors work by several accepted molecular mechanisms. One such theory is substrate competitive inhibition, in which the inhibitor binds to the active site of the Topoisomerase II enzyme, thus preventing DNA binding to the substrate [66]. Presently for this mechanism, no such inhibitor was reported. One more common mechanism which was more popular among the researchers is the formation of 'Topoisomerase poison', which possess a protein-DNA-drug complex that interrupts the DNA re-ligation process and locks the enzyme into 'cleavage complex'. This complex blocks enzyme turn-over and leads to the formation of a cytotoxic complex in the cell. Some compounds like aclarubicin and suramin bind to DNA and thus prevent topoisomerase binding; such compounds provide another potential inhibitory mechanism, although specificity is again an issue with such agents [67, 68]. Compound merbarone binds to the DNA protein complex and prevents cleavage and presents yet another mechanism of catalytic inhibition [69, 70]. Another mechanism that inhibits ATP-hydrolysis-driven enzymatic action is competitive inhibition of the ATP binding site, which is only observed in type II topoisomerase (discussed above). Novobiocin and Coumermycin are examples of ATP-site binders that are not used clinically due to potency, specificity, and poor pharmacokinetic properties [71, 72]. Fig. (7) depicts a pictorial representation of Topoisomerase inhibitors' mechanism of action.
Fig. (7)) Mechanism of action of various drugs as Topoisomerase inhibitors.Topoisomerase inhibitors are categorized as:
(a) Anthracylline inhibitors: Doxorubicin, Epirubicin, Valrubicin(b) Anthracenedione and acridine-derived topoisomerase inhibitors: Mitoxan-trone, Pixantrone, Amsacrine(c) Camptothecin-derived topoisomerase inhibitors: Camptothecin, Irinotecan, Topotecan(d) Epipodophyllotoxin-derived topoisomerase inhibitors: Etoposide, TeniposideThe chemical structures of various Topoisomerase inhibitors are represented in Fig. (8). The anthracyclines were found to have antibiotic and anti-tumour activity; they were extracted from bacterial Streptomyces species for the first time [73]. Doxorubicin, Epirubicin, Valrubicin, Daunorubicin, and idarubicin are the clinically marketed anthracyclines derivatives. The chemical structures of some of them were shown in Fig. (4). Doxorubicin, an anthracyclines derivative, has been used in the treatment of breast cancer, various types of leukeamia, lymphoma, sarcomas, carcinomas, and other tumours [74]. Besides, some other derivatives are indicated for other problems, such as idarubicin for treatment of leukeamia, epirubicin for treatment of breast cancer following resection, and valrubicin to treat urinary bladder carcinoma [74]. Anthracenedione and acridine-derived topoisomerase inhibitors are the synthesized compounds known to act as anthracycline derivatives with lesser side effects [74]. Mitoxantrone, a chemotherapeutic agent used to treat leukaemia and prostate cancer, was discovered to cross the blood-brain barrier and is thus recommended for reducing the frequency and severity of multiple sclerosis relapses [75]. Pixantrone is an aza-anthracenedione that has been approved for the treatment of non-Hodgkin lymphoma. It has cytotoxic effects by intercalating into DNA like anthracyclines, but it also causes long-term cell damage and death by causing errors in mitosis and chromosome segregation [76]. Due to its inability to bind iron and contribute to free radical production in the heart, pixantrone is less toxic than doxorubicin in cardiac muscle cells. Animal models have shown that animals treated with doxorubicin have a lower heart weight than those treated with pixantrone [77, 78]. The topoisomerase poisons derived from camptothecin mainly affect type I topoisomerases. Camptotheca acuminate was the first plant from which alkaloid camptothecin was obtained (a Chinese tree). Topotecan is approved as a second-line treatment for small cell lung cancer and for patients with stage IV-B cervical carcinoma who have not had surgery or radiation [74].
Kinase Inhibitors
Receptor tyrosine kinases, ErbB participates in physiological pathways and cancer. At present, four members of the ErbB family have been known including epidermal growth factor receptor (EGFR), ErbB2, ErbB3, and ErbB4 [79]. Specifically, EGFR and ErbB2 are mutated in many epithelial tumours. The clinical studies revealed their significant roles in cancer development and progression. Therefore, considering the important role played by ErbB receptors in human cancer, efforts have been initiated in developing target-specific therapy [80].
Fig. (8)) Structures and name of diverse heterocyclic scaffolds as Topoisomerase inhibitors with their chemical classes.The ErbB receptors currently constitute the primary targets of anticancer strategies. However, it was frequently observed that members of the ErbB receptor family over-expressed in several human cancers. Researchers under the leadership of Jung reported that Isoliquiritigenin (ISL) reduces cell proliferation and induces apoptosis in DU145 human prostate cancer cells and MAT-LyLu (MLL) rat prostate cancer cells [81]. Shin and colleagues synthesized 16 chromenylchalcones and used a clonogenic long-term survival assay on HCT116 human colorectal cancer cell lines to test them. The IC50 of one of the chromenylchalcones tested compound [82] was 93.1 nM, which is comparable to the IC50 values of well-known flavonoids like catechin gallate and epicatechin gallate. Fig. (9) shows the chemical structure of a kinase inhibitor.
Fig. (9)) Kinase Inhibitor.mTOR Inhibitors
The mTOR (mammalian target of rapamycin) protein is serine/threonine kinase belongs to (PI3-K) phospho-inositide 3 kinase (PI3-K) family, which serve as a master switch in the regulation of cell metabolism, growth, proliferation and survival. It is clear from the published reports that the mTOR pathway got activated and deregulated, controlling various biological processes (e.g. tumour formation and angiogenesis, insulin resistance, adipogenesis and T-lymphocyte activation); if the patient is suffering from cancer or diabetes, the pathway is deregulated while in normal patients it got activated mTOR. Rapamycin inhibits AKT by disrupting the assembly of mTORC2, but only in certain cell types [83]. Chalcones have demonstrated mTOR inhibition in Fig. (10).
Fig. (10)) Pictorial representation of the mechanism of action of mTOR inhibitors.There are several known inhibitors as mTOR antagonists (Fig. 11). To name a few, presently Rapamycin, Temsirolimus, Everolimus are in clinical application. Among the anticancer treatments, Rapamycin derived from the Streptomyces hygroscopicus bacteria found in the soil of Easter Island looks promising to slow down the tumor growth. However, some Rapamycin derivatives have been developed due to their low bioavailability and effectiveness [84]. Temsirolimus was the first rapalog approved by the FDA for the treatment of renal cell carcinoma. It is a prodrug that, when injected, converts to Rapamycin, an ester of hydroxymethyl propionic acid [85, 86].
Fig. (11)) Chemical structure of various mTOR inhibitors.The FDA approved Everolimus, which has a hydroxyethyl group, for the treatment of renal cell carcinoma. Both of these rapalogs outperform rapamycin in terms of pharmacodynamic and pharmacokinetic characteristics [87].
BRAF Inhibitors
BRAF is a type of oncogene protein that directs the production of a protein that aids in transmitting chemical signals from outside the cell to the nucleus. In “RAS-RAF-MEK-ERK” pathway [also known as the mitogen-activated protein kinase (MAPK) cascade], this protein plays a significant role in the signalling pathway, which regulates the proliferation of cells, cell maturation for carrying out specific functions and apoptosis. Mutation in the BRAF gene resulted in oncogenic BRAF, which in turn leads to the generation of the overactive form of protein causing BRAFV600E mutation, thereby allowing BRAF to promote upstream cues. Therefore, these upstream cues result in overactive downstream signalling via MEK and ERK pathways, which causes unnecessary cell proliferation (Fig. 12). Different types of tumours, to name a few melanoma tumours, papillary thyroid tumours, serous ovarian tumours, colorectal and prostate tumours, were generated [87].
Fig. (12)) Pictorial representation and mechanism of action of BRAF inhibitors.Hence, inhibiting the BRAFV600E turns out to be successful in overcoming life-threatening cancer diseases [88]. Also, it seems like a potential therapeutic target as it helps in deactivating the tumour cell proliferation process and increases cell death.
In fact, variety of heterocyclic molecules with different scaffolds have been developed as BRAF inhibitors, including the biarylurea derivative Sorafenib, the triarylimidazole derivative SB-590885, the pyrimidine derivative Dabrafenib, the azaindole derivatives Vemurafenib and PLX4720, and the benzimidazole derivative (RAF265, compound 6).
The Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) granted clinical approval for the treatment of advanced renal cell carcinoma (RCC) and unresectable hepatocellular carcinoma (HCC) in 2005 and 2007, respectively, and it is still in clinical trials for the treatment of other cancers. Its anti-angiogenic effects are mediated by inhibition of receptor tyrosine kinases VEGFR2 and PDGFR, responsible for its clinical activity [89]. Because Sorafenib is non-selective, it has failed to demonstrate therapeutic activity in malignant melanoma treatment [90], most likely due to its low BRAFV600E cell functions. The selective BRAFV600E inhibitor Vemurafenib, on the other hand, showed complete or partial tumour regression in the majority of patients with the BRAFV600E mutation, as well as a longer median survival period. The FDA approved Vemurafenib in 2011 for the treatment of BRAFV600E-mutated unresectable or metastatic melanoma [91]. In animal models, it was recently reported that combining RAF and MEK inhibitors can remove unwanted proliferative effects [91]. Patients treated with a combination of BRAF inhibitor and MEK inhibitor in phase I/II clinical trial had no cutaneous squamous cell carcinoma and had a high objective response rate [92]. Despite the promising clinical efficacy of BRAF inhibitors in cancer treatment, recent studies have shown that these inhibitors are developing substantial drug resistance. Fig. (13) shows BRAF inhibitors and their chemical structures.
Fig. (13)) Chemical structure of heterocyclic drugs as BRAF inhibitors with diverse scaffold.NF-kβ Inhibitors
Nuclear Factor- kappa βeta (NF-kβ) is the mammalian transcription factor, which plays an important role in the regulation of over 150 genes affecting each aspect of cellular adaptation, immunity cell function activation, activation of immune cell function, apoptosis and oncogenesis [93].
