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Etoposide is a topoisomerase II inhibitor. It’s a chemotherapy we use very commonly in small cell lung cancer. It’s actually a natural product that we find in the Mandrake plant. It is renally dosed, so your kidney function needs to be watched beforehand and afterwards to make sure that the dosing is done correctly. There is an oral form of etoposide. And if you have the oral form, it’s twice the dosing that you would give if you gave it IV. It causes a drop in your bone marrow counts, specifically your neutrophils that help you fight bacterial infections, platelets that help you clot and your red blood cells. So we watch your counts for that reason while you’re on etoposide. It can cause hair loss and what we call mucositis, which is basically inflammation or painful lesions in your mouth and mucosal tissues.
You’ll want to let your doctor know if that’s the case, because we can reduce them with extra medications while you’re at home. Rarely, when you get etoposide, you can have a hypersensitivity reaction. Where basically you get kind of short of breath, you get what we call bronchospasm, you get chills. And we think this is from polysorbate in the chemical, but it’s a pretty rare reaction. And that’s why you get it in a treatment room with chemo nurses that can quickly address it if this is the case. One very important thing to know about etoposide, especially in the curative setting as years go forward in your cure, it can cause what’s called acute myeloid leukemia. Specifically what we used to call M4M5. This is important because this means you should get your blood work annually, just like you would routinely, after receiving etoposide to make sure that does not occur.
