Etoposide
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DRUG-ETOPOSIDE |
|---|---|
| Тип | Препарат |
| Синоніми | EtopophosEtoposide phosphate (Etopophos)ToposarVP-16VePesidVepesideЕтопозид |
| Статус | переглянуто 2026-04-26 | очікує клінічного підпису |
| Хвороби | DIS-AITL DIS-AML DIS-ATLL DIS-BURKITT DIS-EATL DIS-HGBL-DH DIS-HSTCL DIS-NK-T-NASAL DIS-PMBCL DIS-PTCL-NOS DIS-SCLC DIS-TESTICULAR-GCT |
| Джерела | SRC-NCCN-BCELL-2025 |
Дані про препарат
| Клас | antineoplastic — topoisomerase II inhibitor (epipodophyllotoxin) |
|---|---|
| Механізм дії | Semi-synthetic podophyllotoxin derivative; stabilizes the cleavable topoisomerase II–DNA complex, preventing strand religation and producing protein-linked DNA double-strand breaks that trigger apoptosis. Cell-cycle S/G2 phase active. Etoposide phosphate (Etopophos) is a water-soluble prodrug rapidly converted to etoposide by serum phosphatases, allowing faster IV administration without solvent reactions. |
| Типове дозування | DA-EPOCH-R (DLBCL / Burkitt / HGBL): 50 mg/m²/day continuous IV days 1-4 (96-h infusion), starting dose; dose-adjusted up by ~20% per cycle if ANC nadir >0.5. BEACOPP escalated (Hodgkin): 200 mg/m² IV days 1-3. ICE (R/R DLBCL pre-ASCT): 100 mg/m² IV days 1-3. ESHAP: 40 mg/m²/day continuous IV days 1-4 (96-h infusion). AML 7+3 alternative / induction reinforcement: 100-150 mg/m² IV days 1-5. HLH-94/2004: 150 mg/m² IV twice weekly × 2 weeks then weekly. BEP (testicular): 100 mg/m² IV days 1-5 every 21 days × 3-4 cycles. |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | True |
| Остання перевірка для України | 2026-04-27 |
Застереження
- Severe myelosuppression (dose-limiting at all schedules)
- Anaphylactoid reactions during IV infusion (avoid rapid bolus; infuse over ≥30-60 min for VP-16, faster acceptable for Etopophos)
- Secondary AML with 11q23 (KMT2A/MLL) translocation — well-documented therapy-related risk
Нотатки
Used widely in heme: DA-EPOCH-R (DLBCL / Burkitt / HGBL / PMBL), BEACOPP-escalated (Hodgkin), ICE / RICE (R/R DLBCL salvage), ESHAP (R/R lymphoma salvage), HLH-94/2004 (hemophagocytic lymphohistiocytosis), AML salvage / induction-intensification protocols, and BEP (germ-cell). Therapy-related AML with 11q23 (KMT2A/MLL fusion) is the principal late toxicity, more frequent with weekly than 3-weekly dosing (cumulative exposure threshold ~2 g/m²). Slow infusion (≥30-60 min) to avoid hypotension and infusion reactions; Etopophos phosphate prodrug allows faster infusion without solvent toxicity. Oral bioavailability variable (~50%) — IV preferred for curative protocols.
Де використовується
Regimens
REG-AAML1031-PEDIATRIC- AAML1031-style induction (Cytarabine + Daunorubicin + Etoposide, pediatric AML 1L)REG-BEP-GCT- BEP (bleomycin + etoposide + cisplatin, germ cell tumor)REG-CE-SCLC- Carboplatin + etoposide (SCLC, 1L)REG-CHOEP- CHOEP (cyclophosphamide + doxorubicin + vincristine + etoposide + prednisone), 6 cyclesREG-CHOEP-ALLOSCT-CONSOLIDATION- CHOEP × 6 + allogeneic SCT consolidation in CR1 (fit transplant-eligible PTCL NOS)REG-CODOX-M-IVAC- CODOX-M / IVAC alternating × 4 (Magrath protocol)REG-DA-EPOCH-R- Dose-Adjusted EPOCH + Rituximab (DA-EPOCH-R), 6 cyclesREG-EP-ATEZO-SCLC- Etoposide-platinum + atezolizumab (extensive SCLC, 1L)REG-EP-CONCURRENT-RT-SCLC-LIMITED- Etoposide-platinum + concurrent thoracic RT (limited SCLC)REG-EP-DURVA-SCLC- Etoposide-platinum + durvalumab (extensive SCLC, 1L)REG-EP-GCT- EP (etoposide + cisplatin, germ cell tumor)REG-ICE- ICE (Ifosfamide + Carboplatin + Etoposide), 3 cyclesREG-R-ICE-PMBCL- R-ICE salvage with autoSCT consolidation (relapsed/refractory PMBCL)REG-RICE-BURKITT- R-ICE (Rituximab + Ifosfamide + Carboplatin + Etoposide) × 2-3 cycles → ASCT in CR2 (r/r...REG-SMILE- SMILE (Steroid + MTX + Ifosfamide + L-asparaginase + Etoposide), 2-4 cycles