Aminophenol Replacement
5a Metabolism-dependent neutrophil cytotoxicity of amodiaquine: a comparison with pyronaridine and related antimalarial drugs
Chem. Res. Toxicol. 1998, 11, 1586-1595
Amodiaquine is a 4-aminoquinoline derivative, which was widely used in the past for both prophylaxis and treatment of malaria. It was withdrawn from use because of fatal side effects, notably agranulocytosis and hepatitis, which occurred mainly in non-immune adults taking the drug for prophylaxis.
Toxicity problems have been attributed to the formation of a quinone-imine metabolite, which undergoes nucleophilic attack (preferentially with nucleophilic thiol group).
Replacing the 4-aminophenol ring by a constrained sp3 amino alcohol would be a good alternative to alleviate metabolism related issues.
5b Human Metabolism of Lapatinib, a Dual Kinase Inhibitor: Implications for Hepatotoxicity
Drug Metab Dispo. 2012, 40(1), 139-150
Lapatinib is an important orally active dual tyrosine kinase inhibitor efficacious in combination therapy for patients with metastatic breast cancer. However, clinically significant liver injury, which may be associated with lapatinib metabolic activation, has been reported. Several of the lapatinib metabolites can undoubtedly be linked to fluorobenzyl oxidative cleavage and formation of reactive species such as quinone imines.
Replacement of phenyl rings by cage like alkyl motifs could alleviate metabolism issues: