etoposidi

Etoposide, known in some languages as etoposidi, is a semi-synthetic chemotherapy agent derived from podophyllotoxin. It acts as a topoisomerase II inhibitor, stabilizing the enzyme-DNA complex and causing DNA double-strand breaks. This prevents DNA replication and leads to cell death, with greater effect on rapidly dividing cancer cells. Etoposide is available in several formulations, including an IV solution and an oral tablet, as well as a water-soluble prodrug, etoposide phosphate, for intravenous use.

Clinical use: Etoposide is used to treat a range of malignancies, including testicular germ cell tumors (often in combination with cisplatin and bleomycin in regimens such as BEP), small cell lung cancer, lymphomas, ovarian cancer, and certain leukemias. It is commonly part of multi-agent regimens and may be used in both adult and pediatric patients depending on the tumor type and stage.

Administration and pharmacokinetics: Etoposide can be given IV or orally. Oral bioavailability is variable, and IV routes provide controlled exposure. The drug is metabolized in the liver and excreted primarily by the kidneys; dose adjustments are often required for hepatic or renal impairment. Etoposide may interact with other myelosuppressive agents and drugs affecting liver enzymes.

Adverse effects: The most common toxicity is myelosuppression, resulting in neutropenia and thrombocytopenia, along with fatigue. Other frequent side effects include nausea, vomiting, mucositis, alopecia, and liver enzyme elevations. Hypersensitivity reactions can occur with certain IV formulations containing solvents. Long-term or high-dose therapy carries a risk of secondary malignancies, particularly therapy-related leukemias. The drug is teratogenic and should be avoided in pregnancy.