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.Etoposide (Vepesid) package insert Etoposide (Vepesid) package insert (locally hosted backup)
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 or the prescribing information.
==Diseases for which it is established==
*Ovarian cancer (PMDA)
*Small cell lung cancer (FDA)
*Testicular cancer (FDA)
==Scenarios for which it is established==
*Cellular therapy conditioning regimens (PMDA)
==Diseases for which it is used==
*Acute lymphoblastic leukemia, infant
*Acute myeloid leukemia
*Acute promyelocytic leukemia
*Carcinoma of unknown primary
*Adrenocortical carcinoma
*Adult T-cell leukemia-lymphoma
*Anaplastic glioma
*Anaplastic large cell lymphoma
*B-cell acute lymphoblastic leukemia
*T-cell acute lymphoblastic leukemia
*Burkitt lymphoma
*Cholangiocarcinoma
*Classical Hodgkin lymphoma
*CNS lymphoma
*Diffuse large B-cell lymphoma
*Esophageal cancer
**Esophageal adenocarcinoma
**Esophageal squamous cell carcinoma
*Ewing sarcoma
*Extranodal NK- and T-cell lymphoma, nasal type
*Gallbladder cancer
*Gestational trophoblastic neoplasia
*Hemophagocytic lymphohistiocytosis
*HIV-associated lymphoma
*Hodgkin lymphoma, nodular lymphocyte-predominant
*Indolent lymphoma
**Follicular lymphoma
*Kaposi sarcoma
*Langerhans cell histiocytosis
*Low-grade glioma
**Low-grade glioma, pediatric
*Mantle cell lymphoma
*Mediastinal gray-zone lymphoma
*Medulloblastoma
*Multiple myeloma
*Neuroblastoma
*NK- and T-cell lymphoma
*Non-small cell lung cancer
**Non-small cell lung cancer, nonsquamous
*Osteosarcoma
*Peripheral T-cell lymphoma
*Primary mediastinal B-cell lymphoma
*Retinoblastoma
*Rhabdomyosarcoma
*Soft tissue sarcoma 
*Thymoma
*Transformed lymphoma
==Patient drug information==
*Etoposide (Vepesid) package insert
*Etoposide (Vepesid) patient drug information (Chemocare)Etoposide (Vepesid) patient drug information (Chemocare)
*Etoposide (Vepesid) patient drug information (UpToDate)Etoposide (Vepesid) patient drug information (UpToDate)
==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 	Synonyms 	Synonyms 	Synonyms 	Synonyms	Synonyms	Synonyms 	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==
Category:Drugs
Category:Intravenous medications
Category:Oral medications
Category:Irritant
Category:Topoisomerase II inhibitors
Category:Acute lymphoblastic leukemia, infant medications
Category:Acute myeloid leukemia medications
Category:Acute promyelocytic leukemia medications
Category:Carcinoma of unknown primary medications
Category:Adrenocortical carcinoma medications
Category:Adult T-cell leukemia-lymphoma medications
Category:Anaplastic glioma medications
Category:Anaplastic large cell lymphoma medications
Category:B-cell acute lymphoblastic leukemia medications
Category:T-cell acute lymphoblastic leukemia medications
Category:Burkitt lymphoma medications
Category:Cholangiocarcinoma medications
Category:Classical Hodgkin lymphoma medications 
Category:CNS lymphoma medications
Category:Diffuse large B-cell lymphoma medications
Category:Esophageal adenocarcinoma medications
Category:Esophageal cancer medications
Category:Esophageal squamous cell carcinoma medications
Category:Ewing sarcoma medications
Category:Extranodal NK- and T-cell lymphoma, nasal type medications
Category:Follicular lymphoma medications
Category:Gallbladder cancer medications
Category:Gestational trophoblastic neoplasia medications
Category:Hemophagocytic lymphohistiocytosis medications
Category:HIV-associated lymphoma medications
Category:Indolent lymphoma medications
Category:Hodgkin lymphoma, nodular lymphocyte-predominant medications
Category:Kaposi sarcoma medications
Category:Langerhans cell histiocytosis medications
Category:Low-grade glioma medications
Category:Low-grade glioma, pediatric medications
Category:Mantle cell lymphoma medications
Category:Mediastinal gray-zone lymphoma medications
Category:Medulloblastoma medications
Category:Multiple myeloma medications
Category:Neuroblastoma medications
Category:Neuroendocrine carcinoma medications
Category:NK- and T-cell lymphoma medications
Category:Non-small cell lung cancer medications
Category:Non-small cell lung cancer, nonsquamous medications
Category:Osteosarcoma medications
Category:Ovarian cancer medications
Category:Peripheral T-cell lymphoma medications
Category:Primary mediastinal B-cell lymphoma medications
Category:Retinoblastoma medications
Category:Rhabdomyosarcoma medications
Category:Soft tissue sarcoma medications 
Category:Small cell lung cancer medications
Category:Testicular cancer medications
Category:Thymoma medications
Category:Transformed lymphoma medications
Category:FDA approved in 1983
Category:EMA approved in 1980
Category:WHO Essential Cancer Medicine