A review of topoisomerase inhibition in lung cancer

Lung cancer is the leading cause of cancer deaths among both males and females. Although there have been several advances in the treatment armamentarium, both small cell and nonsmall cell lung cancer continue to be prognostically poor diseases that are refractory to therapy. Several of the regimens involved in treating the disease include drugs that inhibit the topoisomerase enzymes, whose specific role in relieving torsional strain on DNA to facilitate replication and transcription has long been known. Topoisomerase inhibition, however, has increasingly gained attention because of its efficacy in disease stabilization in lung cancer, with continued elaboration of its exact mechanism in lung cancer therapy. This review presents the biology and molecular mechanics of the topoisomerase enzymes, as well as the effect of their inhibition in SCLC and NSCLC, with discussion of specific drugs and the data to support and explain its use as a chemotherapeutic target in lung cancer.