Table 4.

Examples of antibiotics with antitumor effect and their known mechanisms of action.

Antibiotics	Type of Cancer	Mechanism of Action	Ref
Adriamycin	Malignant lymphoma, breast cancer, lung cancer	- Inhibition of the activity of topoisomerase I and II causing the breakdown of DNA with two strands - Upregulation of p53 - Alteration of the Bcl-2/Bax pathway (changing the Bcl-2/Bax ratio)	[217]
Bleomycin	Lymphomas, germ cell tumors, melanomas, gynecologic cancers	- DNA binding - Production of free radicals (hydroxyl radicals)	[218,219]
Ciprofloxacin	Bladder cancer, colorectal cancer, hepatocellular carcinoma, melanoma, breast cancer	- Inhibition of the activity of topoisomerase II - Impairment of cell cycle at the G2 / M checkpoint	[220,221]
Dactinomycin	Nephroblastoma, chorionic epithelial carcinoma, rhabdomyosarcoma and neuroblastoma	- Specific interaction with deoxyguanine in DNA - Formation of complexes with DNA - Inhibition of the mRNA synthesis	[222,223]
Daunorubicin	Acute myelogenous leukemia, lymphocytic leukemia	- Chimerism between basic DNA pairs - Tight DNA binding - Obstruction of the spatial structure of DNA	[224]
Epirubicin	Breast cancer, malignant lymphoma, soft tissue sarcoma, gastric cancer, malignant melanoma, colon cancer, lung cancer, ovarian cancer	- Direct incorporation between DNA nucleotide pairs - Interfering with the transcription process and inhibiting mRNA formation - Topoisomerase II inhibition	[216]
Gemifloxacin	Breast cancer	- Inhibition of bacterial DNA gyrase and topoisomerase IV - Suppression of activity of NF-kB - Inhibition of the migration and invasion induced by cancer necrosis factor (TNF-α).	[225,226]
Mitomycin	Bladder cancer	- Formation of double cross-links or intrachain with DNA - Inhibition of DNA replication and synthesis - Increase in oxygen radicals	[227,228]
Plicamycin	Testicular embryonal cancer, glioma, lymphoma	- DNA binding - Inhibition of RNA synthesis - Acting on cell proliferation at all stages	[229]