II. Indications
- FDA Approved (often combined with other agents)
- Off-Label
- Acute Myelogenous Leukemia (AML)
- Acute Lymphocytic Leukemia (ALL)
- Breast Cancer
- Choriocarcinoma
- Endometrial Cancer
- Epithelial Ovarian Cancer
- Gastric Cancer
- Hepatocellular Carcinoma
- Kaposi Sarcoma
- Lymphoma (Non-Hodgkin Lymphoma, Hodgkin Lymphoma)
- Neuroblastoma
- Non-Small Cell Lung Cancer
- Rhabdomyosarcoma
- Soft Tissue Sarcoma
III. Mechanism
- See Mitotic Inhibitor Chemotherapy
- Etoposide is a semisynthetic derivative of Podophyllotoxin with antineoplastic activity
- Podophyllotoxin extracted from the mandrake root (Podophyllum peltatum)
- Etoposide is a Topoisomerase Inhibitor
- Binds to topoisomerase 2, inhibiting DNA ligation
- DNA breaks accumulate
- Inhibits DNA Replication and transcription
- Arrests cell cycle in G2 and S phases
- Results in cell apoptosis and death
IV. Medications
- IV Solution: 5, 25 and 50 ml vials
- Oral Capsules: 50 mg
V. Dosing
- See other references for disease specific dosing protocols
VI. Adverse Effects
- Alopecia
- Anaphylaxis
- Hypotension
- Myelosuppression
- Nephrotoxicity
- Secondary Malignancy (esp. Acute Myelogenous Leukemia)
- Somnolence
VII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring
VIII. Drug Interactions
-
Warfarin
- Etoposide may increase INR
IX. Resources
- Etoposide Injection (DailyMed)
- Etoposide Capsule (DailyMed)
- Etoposide (StatPearls)