Etoposide: A plant-derived chemotherapy drug

Etoposide is a commonly used chemotherapy drug. It is a plant alkaloid, derived from the North American Mayapple plant.

Etoposide is in a class of drugs known as topoisomerase II inhibitors; it works by inhibiting a specific enzyme in the cell that unravels DNA. This causes the DNA strands to break and it leads to the death of the cell.

The drug is entering its fourth decade in the service against cancers, having been approved for use by the Food and Drug Administration in 1983.

Etoposide: Uses

Etoposide is a drug that is used against a wide number of cancers. It has been FDA approved for the treatment of germ cell tumors, small cell lung cancer, non-small cell lung cancer, testicular cancer, Hodgkin's lymphoma, several subtypes of non-Hodgkin's lymphoma, cancers of the brain, ovaries, and breasts, as well as adrenocortical cancer and carcinoid tumors. It also has some applications in leukemia.

Rarely used as a single agent, etoposide today finds much of its use as part of combination chemotherapy regimens. It is found in several, including:

• Stanford V
• BEACOPP
• BEAM
• Dexa-BEAM
• Mini-BEAM
• CEP
• CBV
• CEV
• EPOCH and EPOCH-R
• ESHAP
• ICE and RICE

Etoposide: Side Effects

Unlike many other chemotherapy drugs, hair loss is not associated with etoposide. However, many of the other common side effects are—myelosuppression, leukopenia, nausea and vomiting, flu-like symptoms and fatigue.

Having been around for 30 years, the toxicity profile of etoposide is well known and the drug brings few surprises. Unfortunately among them is a marked increased risk for developing secondary acute myeloid leukemia.