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Topoisomerase II Inhibitors

7 drugs
Oncology
Target Attractiveness: Highly Attractive (80%)

About Topoisomerase II

Topoisomerase II is an enzyme essential for DNA replication, transcription, and chromosome segregation. It relieves torsional stress by cutting and re-ligating DNA strands during these processes. Inhibiting Topoisomerase II disrupts DNA metabolism, leading to cell death, particularly in rapidly dividing cancer cells.

Strategic Insights

ℹ️ How we calculate
  • Validated target with strong trial activity and 80% attractiveness score.
  • phase1 represents biological uncertainty with 57% completion.
7
Approved Drugs
5
Companies
14
Indications
1
Therapeutic Areas
Broadest Approval
DOXORUBICIN HYDROCHLORIDE (LIPOSOMAL)
Baxter
10
approved indications

Top Drugs

DOXORUBICIN HYDROCHLORIDE (LIPOSOMAL)
Baxter
10 indications · 2013
DOXIL (LIPOSOMAL)
Baxter
10 indications · 1995
AVOPEF
AVYXA HOLDINGS
2 indications · 2026
🏢

Six companies have approved drugs targeting Topoisomerase II, including EPIC PHARMA LLC and Pfizer.

Drug Modality Landscape

Modalities

Small molecule
7
100%

Routes of Administration

💉 IV
4
57%
💉 Injection
3
43%
💡

Topoisomerase II is druggable by small molecules, though no oral formulations are currently approved.

The modality landscape suggests an opportunity to explore alternative modalities like antibodies or PROTACs.

Small molecules only

Clinical Trials 1,745 trials

1,745
Total Trials
717
Active
677
Completed
67%
Completion Rate

Completion by Phase

Phase Total Completed Failed Active Completion
Phase 1 613 283 151 172 65%
Phase 2 811 275 153 377 64%
Phase 3 299 108 34 153 76%
Phase 4 22 11 2 9 85%

Top Sponsors

National Cancer Institute (N... 124 72%
M.D. Anderson Cancer Center 107 64%
Hoffmann-La Roche 48 81%
Children's Oncology Group 43 94%
St. Jude Children's Research... 40 55%
University of Washington 29 65%
City of Hope Medical Center 26 55%
Fred Hutchinson Cancer Center 25 63%

By Modality

Small molecule
1745 67%
Source: ClinicalTrials.gov · Completion rate = completed ÷ (completed + terminated + withdrawn)

Phase 3 Readout Calendar Pro

8 Phase 3 trials testing approved Topoisomerase II drugs across all sponsors.

Full calendar →
Q3 2026
Pembrolizumab
Merck Sharp & Dohme LLC · Lung Neoplasms
Estimated · aging NCT04380636
Q3 2026
pembrolizumab/vibostolimab
Merck Sharp & Dohme LLC · Carcinoma, Non-Small-Cell Lung
Estimated · aging NCT05298423
Q2 2027
Odronextamab
Regeneron Pharmaceuticals · B-Cell Non-Hodgkin Lymphoma (B-NHL)
Estimated · fresh NCT06230224
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Coverage: trials whose intervention is an approved drug targeting Topoisomerase II. Pre-approval candidates with development codes (e.g. AZD0901, MK-7240) are not yet linked. Anchored on CT.gov primary completion date.

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Competitive Landscape

  • 5 companies competing
  • Market share by company

Full Drug Portfolio

  • All 7 approved drugs
  • Approval dates & indications

Genetic Validation

  • Full genetic evidence table
  • Effect sizes & directions

Approval Timeline

  • Full 7-drug timeline
  • First-of-modality markers

Clinical Trials Analysis

  • Competition: High (15 sponsors)
  • Success rates by condition
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Full summary • All drugs • Genetic evidence • Trials • Timeline

How We Calculate These Metrics

Target Attractiveness Score

A 0-100 score based on trial activity, sponsor diversity, and completion rates. Calculated from 1122 clinical trials targeting Topoisomerase II.

Completion rate: Percentage of trials that reached their planned endpoint. Trials terminated early, withdrawn, or suspended are not counted—these often indicate safety issues, lack of efficacy, or strategic pivots.

  • Highly Attractive (80+): High trial activity, many sponsors, strong completion rates
  • Attractive (60-79): Good trial activity and validation
  • Moderate (40-59): Moderate interest from sponsors
  • Low (under 40): Limited trial activity or validation concerns

Strategic Insights

Auto-generated insights based on trial analytics including competition intensity, white space opportunities, modality shifts, and failure patterns. We analyze trial sponsors, phases, indications, and outcomes.

Risk Signals

  • High Competition: Many sponsors competing for this target (may reduce market opportunity)
  • High Failure Risk: Low trial completion rates suggest development challenges
  • Low Validation: Limited trial activity or poor outcomes indicate uncertain viability
  • White Space Available: Underexplored indications present opportunities