Used primarily in cancer treatment, particularly for acute leukemias, this compound functions as a chemotherapeutic agent by intercalating into DNA and inhibiting topoisomerase II, which disrupts DNA replication and RNA transcription in rapidly dividing tumor cells. Its modified ketal structure enhances stability and alters cellular uptake, potentially improving pharmacokinetics compared to the parent anthracycline. It is investigated for use in drug-resistant cancers due to its ability to evade certain efflux mechanisms. Research also explores its incorporation into liposomal formulations to reduce cardiotoxicity and increase tumor targeting.