“…On the other hand, through extensive structure-activity relationship studies, several potent and promising derivatives of PPT, such as NK-611(6), GL-331 (7), NPF (8), azatoxin (9), and TOP-53 (10), have also been obtained through numerous chemical modifications on the cyclolignan skeleton and reached phase I and phase II clinical trials as antitumor agents. For example, NK-611, a 2"-dimethylamino derivative of etoposide, was more potent than etoposide in DNA topoisomerase II (topo II) inhibition and cytotoxicity assays against a variety of human cancer lines [5,6]; GL-331 induced topo II dependent DNA cleavage and G-2 phase arrest, and was also shown to be active against many multidrug-resisitant cancer cell lines [7,8]; Azatoxin was designed using molecular modeling of the pharmacophore and was almost as potent as etoposide in inhibiting topo II [9,10]; TOP-53 exhibited more effective antitumor activity than etoposide against several types of cancer, especially lung metastatic tumors [11,12].…”