Medicinal chemistry perspectives on anticancer drug design based on clinical applications (2015-2025)

Abstract

Cancer therapy has undergone a remarkable evolution over the past few decades, driven largely by innovations in medicinal chemistry. This review explores the pivotal role of medicinal chemistry in designing, optimizing, and classifying anticancer agents, from traditional cytotoxics to modern targeted therapies, immunotherapies, and radiotheranostics. The article categorizes FDA-approved anticancer drugs (2015-2025), evaluates their mechanisms of action, structural features, and structure-activity relationships (SAR), and highlights both success stories and challenges in clinical translation. Additionally, it examines withdrawn agents and investigational drugs currently in clinical trials, providing insights into emerging modalities such as PROTACs, antibody-drug conjugates, molecular glues, and AI-driven drug discovery. This synthesis underscores how structure-based drug design, pharmacokinetic modeling, and bioengineering approaches continue to shape the landscape of cancer treatment. Ultimately, medicinal chemistry remains at the heart of the drug development pipeline, offering refined tools for precision oncology and the future of personalized cancer care.

Fig. 1. Classifications of anticancer drugs.

Fig. 2. SAR illustration of some FDA-approved drugs: tyrosine kinase inhibitors (A), kinase inhibitors (B), alkylating agents (C), combination chemotherapy regimens (D), and other targeted therapies (E).

Fig. 3. SAR illustration of investigational drugs: targeted small molecules (A), epigenetic inhibitors (B), enzyme-based therapies (C), radiopharmaceuticals (D), PROTACs/AR pathway inhibitors (E), metabolic/lipid pathway inhibitors (F), cytotoxic nucleoside analogs (G), and MET/SMO kinase inhibitors (H).

Fig. 4. SAR illustration of withdrawn drugs: kinase inhibitors (A) and cytotoxic/alkylating agents (B).