Beyond platinums: gold complexes as anticancer agents

The accidental discovery of the anticancer properties of cisplatin in the mid-1960s triggered the development of alternative platinum-based drugs. However, the platinum-based treatment of tumor diseases is massively hampered by severe side-effects and development of resistance. Sulfur-containing biomolecules play a significant role in platinum anticancer chemotherapy because of their high affinity to the platinum(II) ion. Sulfur is involved in the entire metabolic processing of platinum drugs. Strong and irreversible binding of cisplatin to intracellular thiolato ligands is considered a major step of inactivation, and reactions with sulfur donors in proteins are believed to affect enzymatic processes. Consequently, the development of novel metal-based compounds with a pharmacological profile different from that of clinically-established platinum drugs is a major goal of modern medicinal chemistry and drug design. Among the non-platinum antitumor agents, gold(III) complexes have recently gained increasing attention due to their strong tumor cell growth-inhibiting effects, generally achieved by exploiting non-cisplatin-like mechanisms of action. The real breakthrough is not simply the use of gold compounds to treat cancer, but the rational design of gold-based drugs which may be very effective, non-toxic and potentially selective towards cancer cells, their potential impact relying on the possible site-specific delivery in localized cancer, thus strongly improving cellular uptake and minimizing unwanted side-effects. Cancer cells are known to overexpress specific proteins and receptors needed for tumor growth. Among them, two integral plasma membrane proteins mediate the cellular uptake of di- and tripeptides and peptide-like drugs. They are present predominantly in epithelial cells of the small intestine, bile duct, mammary glands, lung, choroid plexus, and kidney but are also localized in other tissues and are up-regulated in some types of tumors. Accordingly, we have been designing gold(III)-peptide dithiocarbamato derivatives which combine both the antitumor properties and reduced side-effects of the previously reported gold(III) analogues with enhanced bioavailability and tumor selectivity achieved by exploiting peptide transporters. Our compounds showed interesting cytotoxic properties towards a number of cancer cell lines in vitro and in vivo on xenograft models, together with negligible organ and acute toxicity. With respect to their mechanisms of action, we identified mitochondria and proteasome as major in vitro and in vivo targets. These results allowed the filing of an international patent for the use of gold(III) peptidomimetics in cancer chemotherapy, as well as providing a solid starting point for them to enter phase I clinical trials in a few months.