ucleoside antimetabolites, such as 1-β-D-arabinofuranosylcytosine (araC), 2-chloro-2′-deoxyadenosine (CldA), 9-β-D-arabinofuranosyl-2-fluoroadenine 5′-monophosphate (fludarabine, FaraAMP) and 2′-deoxy-2′,2′-difluorocytidine (gemcitabine, dFdC) ( Fig. 1), have been widely used not only as antileukemic agents, but also as antitumor agents against solid tumors.1) Like other nucleoside antimetabolites, such as antiviral agents, these nucleosides are not active components themselves, but have to be metabolically activated by phosphorylation. Therefore, two of the most important factors for effective clinical use are the substrate specificities of nucleoside kinases and the expression levels of the kinases in tumor tissues of patients. The target enzymes of the metabolized nucleotides are different. AraC 5′-triphosphate (araCTP) is incorporated into DNA, and becomes a trigger for apoptosis. 2-Chloro-2′-deoxyadenosine 5′-triphosphate (CldATP) is incorporated into DNA by DNA polymerase and also potently inhibits ribonucleotide reductase (RDR) in place of dATP.2) Fludarabine 5′-triphosphate (FaraATP) is incorporated into both DNA and RNA, causing inhibition of DNA and RNA polymerases. Moreover, FaraATP inhibits RDR as well as DNA ligase 1 and DNA primase.2) Gemcitabine 5′-diphosphate (dFdCDP) is a very potent inhibitor of RDR, and its corresponding 5′-triphosphate (dFdCTP) inhibits DNA polymerase.3) Such differences in target enzymes of nucleotide antimetabolites must be important for the activity against the target diseases. Therefore, further development of new types of nucleoside antimetabolites could be a very effective strategy for fighting tumors. In this review, we describe the design, in vitro cytotoxicity, in vivo antitumor activity, metabolism and mechanism of action of new sugarmodified cytosine nucleosides, such as (2′S)-2′-deoxy-2′-C-methylcytidine (SMDC), 1-(2-deoxy-2-methylene-β-D-erythropentofuranosyl)cytosine (DMDC), 1-(2-C-cyano-2-deoxy-1-β-D-arabino-pentofuranosyl)cytosine (CNDAC) and 1-(3-C-ethynyl-β-D-ribo-pentofuranosyl)cytosine (ECyd), which we have been developing in our labs.
4)
Deoxycytidine kinase-dependent chemotherapyIn mammalian cells and tissues, there are four nucleoside kinases, deoxycytidine kinase (dCK), thymidine kinase-1 (TK1), adenosine kinase (AK) and uridine/cytidine kinase (UCK), in cytosol and two nucleoside kinases, thymidine kinase-2 (TK2) and deoxyguanosine kinase (dGK), in mitochondria.5-7) Many of the antitumor nucleosides in clinical use, such as araC, CldA, dFdC and araG derivatives are phosphorylated by dCK to afford the corresponding 5′-monophosphates, which are further phosphorylated by nucleoside monophosphate kinases and then nucleoside diphosphate kinases (NDPK) (Fig. 2). Among the nucleoside kinases, dCK seems most suitable for activation of the above-described nucleosides to exhibit antitumor efficacy: 1) dCK is constitutively expressed at both the protein and mRNA levels, being unrelated to cell cycle regulation. 2) dCK has the broadest substrate specificity among...