Etoposide (Vepesid)

General information

Class/mechanism: Topoisomerase II inhibitor. Causes DNA strand breaks by interacting with DNA-topoisomerase II or by forming free radicals. Causes arrest at the G2 portion of the cell cycle, with dose dependent effects: at high concentrations, cells entering mitosis undergo lysis; at low concentrations, cells are inhibited from entering prophase.^[1]^[2]
Route: IV, PO
Extravasation: irritant

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.^[1]

Diseases for which it is established (work in progress)

Non-Hodgkin lymphoma
- Follicular lymphoma
- Peripheral T-cell lymphoma

Diseases for which it is used

Patient drug information

History of changes in FDA indication

1983-11-10: Initial FDA approval for refractory testicular tumors. (No supporting studies are cited)
Uncertain date: Approed for small cell lung cancer, in combination with cisplatin, as first-line treatment. (Based on Hainsworth et al. 1995)

History of changes in EMA indication

1980-07-09: EURD

History of changes in PMDA indication

2012-02-22: New additional indication and a new dosage for the treatment of ovarian cancer which has progressed after cancer chemotherapy.
2019-03-26: New indication for the treatment prior to tumor-specific T-cell infusion therapy.

Also known as

Code names: VP-16, VP-TEC, VP-16213
Generic name: etoposide phosphate
Brand names:

Synonyms
Aside	Beposid	Bioposide	Celltop	Citodox	Epocin	Eposid	Eposide
Eposido	Eposin	Epsidox	ETO	Etocris	Etomedac	Etonolver	Etopofos
Etopophos	Etopos	Etoposid	Etoposido	Etopoxan	Etopul	Etosid	Etosin
Eunades CS	Euvaxon	Exitop	Fytop	Fytosid	Labimion	Lastet	Lastet S
Neoplaxol	Nexvep	Onkoposid	Optasid	Percas	Posid	Posidon	Posyd
Riboposid	Sintopozid	Toposar	Toposide	Toposin	Topresid	Tosuben	Vepefos
Vepesid	Vepeside	Vepsid	Vepside

References

[insert-1] 1.0 ^1.1 ^1.2 Etoposide (Vepesid) package insert

[2] Etoposide (Vepesid) package insert (locally hosted backup)

[3] Etoposide (Vepesid) patient drug information (Chemocare)

[4] Etoposide (Vepesid) patient drug information (UpToDate)

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