Etoposide cancer treatment

Podophyllum peltatum (mayapple)

Etoposide is a commonly-used chemotherapy drug derived from the toxin podophyllotoxin, found in Podophyllum peltatum, also known as the Mayapple, a North American plant. Etoposide has been in use as an anticancer agent for nearly three decades.

Drug profile

  • Class: Topoisomerase II inhibitor
  • Mechanism of action: Etoposide inhibits a specific enzyme in the cell that unravels DNA, causing the strands to break and leading to cell death.
  • Treatment type: Chemotherapy
  • US approval: 1983
  • Synonyms: VePesid, Toposar, VP-16
  • FDA Use-in-Pregnancy Rating: Category D

What Etoposide is effective for and why

Etoposide has many anti-cancer applications. It has been used to treat germ cell tumors, small cell lung cancer, non-small cell lung cancer, acute myeloid leukemia, testicular cancer, Hodgkin lymphoma, non-Hodgkin lymphomas, adrenocortical cancer, carcinoid tumors, brain cancer, breast cancer, and ovarian cancer. Etoposide is featured in several combination chemotherapy regimens, chiefly for the lymphomas. These include CBV, CEP, I-VAC, BEAM, Dexa-BEAM, Mini-BEAM, Stanford V, BEACOPP, CEVD, CAPE/PALE, EPOCH, ESHAP, ICE and R-ICE.

Etoposide is a commonly used component of preparative salvage regimens given to patients prior to undergoing bone marrow transplantation.

Etoposide side effects: Overview

While each patient will have his or her own experiences with the side effects of etoposide, most patients will likely experience myelosuppression (leukopenia), and those receiving oral etoposide are more prone to experience nausea and/or vomiting than those receiving the drug by IV. Otherwise, patients may endure flu symptoms, loss of appetite, increased heart rate, fatigue, skin rash, and possibly some hair loss. Most if not all of these side effects should subside when one is finished with receiving etoposide. Patients are encouraged to report all side effects to their oncologist or oncology team.

Additionally, secondary cancers—in the form of acute myeloid leukemia—have been reported and closely associated with etoposide.

Sources

  • Boyiadzis, Michael M. et al. Hematology-Oncology Therapy. 2007. New York: McGraw Hill, Medical Publishing Division.
  • Guide to Cancer Drugs, American Cancer Society
  • Cancer Drug Manual, BC Cancer Agency
  • Perry, Michael C, Editor. Companion Handbook to the Chemotherapy Sourcebook. 1999. Baltimore; Williams & Wilkins.
  • Drugs.com: Etoposide

Significant studies relating to etoposide


 

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