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This review focuses on the synthesis and mechanisms of antitumor activity of cationic nonphosphorus analogs of edelfosine. The role of variable length and mode of conjugation of the spacer group, the types of cationic 'head', and the length of the substituent at C(2) atom of the glycerol backbone are discussed, providing the basis for rational design of lipophilic anticancer drugs, in particular, for elimination of multidrug resistant cells.