Figure 5.

The role of metabolism and microRNA (miRNA) in daunorubicin and cytarabine treatment. While daunorubicin is an active drug, cytosine requires bio-activation. As a cytosine analog, it must undergo three phosphorylation steps to become fully activated and capable of incorporating into the genome. The deactivation of daunorubicin and cytarabine is partially dependent on the cytochrome P450s and they commonly share CYP3A4 in their pathway of degradation. In other cancer, CYP3A4 has been shown to be targeted by miR-27b, miR-298, miR-577, miR-1, miR-532-3p, and miR-627. In the pathway of cytarabine activation, deoxycytidine kinase (DCK) has been shown to be downregulated by miR-330 in other cancers.