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Etoposide (VP-16)

Alias: Demethyl Epipodophyllotoxin; Ethylidine Glucoside; epipodophyllotoxin; trans-Etoposide; (-)-Etoposide; Lastet; Zuyeyidal; US brand names: Toposar; VePesid. Foreign brand name: Lastet. Abbreviation: EPEG Code names: VP16; VP16213;
Cat No.:V1390 Purity: ≥98%
Etoposide (formerly VP-16, VP-16213; Toposar; VePesid; Lastet; EPEG), a chemotherapeutic drug used for the treatments of various cancers, is a semisynthetic derivative of the naturally occuring podophyllotoxin which inhibits DNA synthesis via topoisomerase II inhibitory activity.
Etoposide (VP-16)
Etoposide (VP-16) Chemical Structure CAS No.: 33419-42-0
Product category: Topoisomerase
This product is for research use only, not for human use. We do not sell to patients.
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Other Forms of Etoposide (VP-16):

  • Etoposide Phosphate (BMY-40481)
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Purity & Quality Control Documentation

Purity: ≥98%

Product Description

Etoposide (formerly VP-16, VP-16213; Toposar; VePesid; Lastet; EPEG), a chemotherapeutic drug used for the treatments of various cancers, is a semisynthetic derivative of the naturally occuring podophyllotoxin which inhibits DNA synthesis via topoisomerase II inhibitory activity. The mandrake root, Podophyllum peltatum, is used to extract etoposide. It binds to topoisomerase II and inhibits it, giving it strong anticancer properties. Etoposide inhibits DNA replication and transcription, causes apoptosis in cells, and accumulates single- or double-strand breaks in DNA molecules by ligating the broken DNA molecules. The G2 and S phases of the cell cycle are when etoposide primarily acts.

Biological Activity I Assay Protocols (From Reference)
Targets
Topoisomerase II
ln Vitro

Etoposide inhibits to DNA and forms a complex with topoisomerase II, which causes breaks in double-stranded DNA and stops topoisomerase II from binding to repair it. This inhibits DNA synthesis. Cell death results from cumulative DNA breaks that prohibit cells from entering the mitotic phase of division. The G2 and S phases of the cell cycle are when etoposide primarily acts.[1] With an IC50 of 0.25 μg/mL, Etoposide inhibits the growth of the ISOS-1 murine angiosarcoma cell line over a period of 5 days. Normal mouse microvascular endothelial cells (mECs) have an IC50 of 10 μg/mL, which indicates that they are less sensitive to etoposide.[2] At an IC50 of 0.6 μM, etoposide treatment for six hours inhibits the growth of tetraploid variant human leukemic lymphoblast line CCRF-CEM.[3] Two hours of Etoposide treatment inhibits the growth of human pancreatic cancer cell lines Y1, Y3, Y5, Y19, YM, YS, and YT, with IC50s of 300 μg/mL, 300 μg/mL, 300 μg/mL, 91 μg/mL, 0.68 μg/mL, 300 μg/mL, 300 μg/mL, and 260 μg/mL, respectively.[4] Human glioma cell lines CL5, G142, G152, G111, and G5 grow less when exposed to Etoposide for one hour. The IC50 values for these cell lines are 8, 9, 9.8, 10, and 15.8 μg/mL, respectively, and they last for 12 days. Cell lines CL5, G152, G142, and G111 reach the IC90 value at 26, 27, 32, and 33 μg/mL under the same conditions. Topoisomerase II is uniformly inhibited by etoposides in every cell. For 1, 2, 4, 8, and 16 μg Etoposide, the average inhibition rates are 15%, 21.8%, 31.8%, 41.5%, and 49.5%, in that order.[5]

ln Vivo
In an in vivo assay, tumor growth of ISOS-1 was significantly inhibited by more than 2.5 mg/kg of ETO dose-dependently, and by more than 30 mg/kg of TNP-470, and 100 mg/kg of PSL individually. Combination treatments of ETO+TNP-470 and TNP-470+PSL showed synergistic enhancement of inhibition (% control inhibition: ETO vs. TNP-470 vs. ETO+TNP-470: 55 versus 55 vs. 16%) (% control inhibition: TNP-470 vs. PSL vs. TNP-470+PSL: 41 vs. 86 vs. 21%). ETO+PSL combination treatment, however, failed to show significant enhancement of anti-tumor effects. In conclusion, our results indicated that TNP-470 may be a very effective drug for angiosarcoma treatment, especially in combination with ETO or PSL. We eagerly anticipate the use of TNP-470 in clinical treatment of angiosarcoma.[2]
These results support the hypothesis that in addition to its antineoplastic cytotoxic effect, VP-16 induces changes in 3LL cells which are recognized by the host immune system resulting in immune rejection of 3LL. often immunosuppressive and therapeutic advantage is generally based on the tumor cytotoxicity of individual drugs or combinations of drugs [13]. Our earlier work showed a link between the use of cytotoxic chemotherapy with etoposide (VP-16) and the induction of an immune response against syngeneic murine leukemia in the intact host [16]. VP-16 is an immunosuppressive topoisomerase II-inhibiting drug which induces tumor cell apoptosis and is frequently used clinically to treat a variety of tumors [1, 3, 9, 10]. We have noted that the addition of cyclosporin A to VP-16 produces CD8 T lymphocyte-mediated tumor-specific immunity in mice bearing L1210 leukemia [17]. We have extended these experiments to a spontaneously arising non-carcinogen-induced neoplasm, Lewis lung cancer (3LL), and now report that surviving mice successfully treated with VP-16, in the absence of cyclosporin A, reject challenge with 3LL. In addition, results are presented to show that VP-16 modifies 3LL cells rendering them immunogenic. These findings are submitted to support the hypothesis that VP-16-induced cytotoxic changes include cellular membrane alterations in 3LL cells which are recognized by the immune system and cause rejection of this syngeneic lung tumor.[4]
Etoposide administered as a single agent has been shown to be ineffective in the growth of many xenografts, including human neuroblastoma xenograft[7], human gastrointestinal cancer xenograft [8], and heterotransplanted hepatoblastoma NMHB1, and NMHB 2[6]. However, the dose of 10 mg/kg i.p. Etoposide inhibits 36% of controls' murine angiosarcoma cell ISOS-1 tumors. Lewis lung cancer is treated with etoposide to induce tumor immunity. Lewis lung cancer cell (3LL) injections in C57B1/6 mice result in a 60% survival rate after a single 50 mg/kg intraperitoneal injection. This survival rate lasts for 60 days. While none of the control mice survive for more than 30 days, about 40% of these surviving mice reject a subsequent challenge with 3LL. Seventy-five percent of recipient mice are killed by 3LL cells that have withstood a 90% lethal concentration of etoposide in vitro; however, sixty percent of surviving mice reject challenge with 3LL. When naive mice are injected with 3LL, spleenocytes taken from tumor-rejecting mice provide protection.[9]
Enzyme Assay
Nuclei are isolated and nuclear extracts are prepared. The percentage of decatenation obtained is used to calculate the activity of topoisomerase II. The substrate is tritiated kinoplast DNA (KDNA 0.22 μg). After 30 minutes of incubation at 37 °C, etoposide and topoisomerase II are stopped with 100 μg/mL of proteinase K and 1% sodium dodecyl sulfate (SDS). We obtain the percentages of topoisomerase II decatenation and inhibition by etoposide.
Cell Assay
Cells treated with etoposide are removed from the dish and diluted into culture dishes in an amount sufficient to produce 20–200 colonies. The phosphate-buffered saline (PBS) solution contains 0.03% trypsin and 0.27 mM ethylenediaminetetraacetic acid (EDTA). Methanol-acetic acid is used to fix the cultures after 12 days, crystal violet is used for staining, and colonies with more than 50 cells are scored. Unless otherwise specified, standard errors are usually less than 15% of the mean value.
To develop effective therapies for angiosarcoma, we investigated the anti-tumor effects of etoposide (ETO), TNP-470 and prednisolone (PSL) using an established murine angiosarcoma cell line (ISOS-1). We examined the direct anti-tumor and anti-angiogenic effects of these drugs on ISOS-1 cells and normal murine microvascular endothelial cells (mECs) in vitro. Cell growth of ISOS-1 was inhibited significantly by ETO, moderately by TNP-470, and not at all by PSL (IC(50): 0.25 microg/ml, 10 microg/ml, >8000 microg/ml, respectively). One the other hand, cell growth of mECs was inhibited significantly by TNP-470, slightly by PSL, and negligibly by ETO (IC(50): 0.85 ng/ml, 0.7 microg/ml, 10 microg/ml, respectively). [2]
Animal Protocol
Of C57B1/6 mice injected with 10(6) Lewis lung cancer (3LL) cells followed by treatment with a single 50 mg/kg dose of etoposide (VP-16), 60% survived over 60 days, in contrast to untreated control mice which died within 30 days. Approximately 40% of surviving mice rejected a subsequent challenge with 3LL. Their splenocytes protected naive mice injected with 3LL. To test if VP-16 treatment produced alterations in 3LL cells, which induce host immunity, leading to tumor rejection, C57B1/6 mice were injected with 3LL cells that had survived an 80-90% lethal concentration of VP-16 in vitro. These cells killed 75% of recipient mice but 60% of the surviving mice rejected challenge with 3LL. Splenocytes harvested from tumor-rejecting mice protected naive mice injected with 3LL.[4]
Murine angiosarcoma xenografts ISOS-1; 10 mg/kg; i.p. every day for 5 days from day 7
Murine angiosarcoma xenografts ISOS-1
ADME/Pharmacokinetics
Absorption, Distribution and Excretion
Absorbed well, time to peak plasma concentration is 1-1.5 hrs. Mean bioavailability is 50% (range of 25% - 75%). Cmax and AUC values for orally administered etoposide capsules display intra- and inter-subject variability. There is no evidence of first-pass effect for etoposide.
Etoposide is cleared by both renal and nonrenal processes, i.e., metabolism and biliary excretion. Glucuronide and/or sulfate conjugates of etoposide are also excreted in human urine. Biliary excretion of unchanged drug and/or metabolites is an important route of etoposide elimination as fecal recovery of radioactivity is 44% of the intravenous dose. 56% of the dose was in the urine, 45% of which was excreted as etoposide.
The disposition of etoposide is a biphasic process with a distribution half-life of 1.5 hours. It does not cross into cerebrospinal fluid well. Volume of distribution, steady state = 18 - 29 L.
Total body clearance = 33 - 48 mL/min [IV administration, adults]
Mean renal clearance = 7 - 10 mL/min/m^2
Excretion of etoposide in breast milk was demonstrated in a woman with acute promyelocytic leukemia receiving daily doses of 80 mg/sq m (route not stated). Peak concentrations of 0.6 to 0.8 ug/mL were measured immediately after dosing but had decreased to undetectable levels by 24 hr.
Thirty minutes after intravenous administration of etoposide to rats, the highest concentrations were found in the liver, kidneys and small intestine. By 24 hr after the dose, the tissue concentrations were negligible.
After intravenous infusion (5 min) of etoposide phosphate to beagle dogs at doses of 57-461 mg/sq m, a dose-proportional increase was seen in the maximal plasma concentration and AUC for etoposide. The total plasma clearance rate (342-435 mL/min per sq m) and the distribution volume (22-27 L/sq m) were not dose-dependent. The peak plasma concentration occurred at the end of the infusion of etoposide phosphate, indicating rapid conversion of the pro-drug to etoposide.
Less than 4% of a dose was recovered in the bile after 48 hr in patients with biliary drainage tubes. The fecal recovery of radiolabel after intravenous administration of 3(H)etoposide (130-290 mg/sq m) was variable, representing 0-16% of dose, but the collections were known to be incomplete because of fecal retention and other difficulties associated with the poor general condition of many of the patients). In a study reported as an abstract in four patients with small-cell lung cancer given 14(C)-glucopyranoside etoposide, 56% of the radiolabel was recovered in urine and 44% in feces over five days, for a total recovery of 100 +/- 6%.
For more Absorption, Distribution and Excretion (Complete) data for ETOPOSIDE (18 total), please visit the HSDB record page.
Metabolism / Metabolites
Primarily hepatic (through O-demethylation via the CYP450 3A4 isoenzyme pathway) with 40% excreted unchanged in the urine. Etoposide also undergoes glutathione and glucuronide conjugation which are catalyzed by GSTT1/GSTP1 and UGT1A1, respectively. Prostaglandin synthases are also responsible for the conversion of etoposide to O-demethylated metabolites (quinone).
The proposed hydroxy acid metabolite of etoposide, formed by opening of the lactone ring, has been detected in human urine, but only at low concentrations, accounting for 0.2-2.2% of the administered dose.
The major urinary metabolite of etoposide in humans is reported to be the glucuronide conjugate. Although urinary glucuronide and/or sulfate conjugates were reported to account for 5-22% of an intravenous dose of etoposide, other studies suggest that the glucuronide predominates. Etoposide glucuronide in the urine of treated patients accounted for 8-17% of a dose of 0.5-3.5 g/sq m etoposide and 29% of a dose of 100-800 mg/sq m etoposide, with no other metabolites other than etoposide glucuronide detected in the latter study. In patients with renal or liver impairment given somewhat lower doses of 70-150 mg/sq m, 3-17% of the dose was excreted in the urine within 72 hr as etoposide glucuronide.
Etoposide appears to be metabolized principally at the D ring to produce the resulting hydroxy acid (probably the trans-hydroxy acid); this metabolite appears to be pharmacologically inactive. The picrolactone isomer of etoposide has been detected in two concentrations in the plasma and urine of some patients but not in others. The aglycone of etoposide and/or its conjugates have not been detected to date in patients receiving the drug. In vitro, the picrolactone isomer and aglycone of etoposide have minimal cytotoxic activity.
Generally, few or no etoposide metabolites have been detected in plasma. Etoposide is administered as the trans-lactone, but cis-etoposide can also be detected in human urine. This might be a storage phenomenon, since isomerization sometimes occurs during freezing of plasma samples under slightly basic conditions. The cis isomer accounts for < 1% of the dose. The catechol metabolite has also been reported in patients receiving 600 mg/sq m etoposide, with an AUC of around 2.5% that of etoposide. In patients given 90 mg/sq m etoposide, the catechol metabolite represented 1.4-7.1% of the urinary etoposide and < 2% of the administered dose.
In rat liver homogenates, liver microsomes and in rats in vivo, etoposide was extensively metabolized to only one major metabolite, which was not formally identified. In perfused isolated rat liver incubated with etoposide, the total recovery in bile was 60-85%, with roughly equal amounts of etoposide and two glucuronide metabolites, confirmed as glucuronide species by liquid chromatography and mass spectrometry. After intravenous injection of 3(H)etoposide to rabbits, the total urinary excretion of radiolabel was 30% after five days, with very little thereafter. A single glucuronide metabolite was identified in rabbit urine, which was present in larger amounts than etoposide. No hydroxy acid was identified in either species.
Primarily hepatic (through O-demethylation via the CYP450 3A4 isoenzyme pathway) with 40% excreted unchanged in the urine. Etoposide also undergoes glutathione and glucuronide conjugation which are catalyzed by GSTT1/GSTP1 and UGT1A1, respectively. Prostaglandin synthases are also responsible for the conversion of etoposide to O-demethylated metabolites (quinone).
Route of Elimination: Etoposide is cleared by both renal and nonrenal processes, i.e., metabolism and biliary excretion. Glucuronide and/or sulfate conjugates of etoposide are also excreted in human urine. Biliary excretion of unchanged drug and/or metabolites is an important route of etoposide elimination as fecal recovery of radioactivity is 44% of the intravenous dose. 56% of the dose was in the urine, 45% of which was excreted as etoposide.
Half Life: 4-11 hours
Biological Half-Life
4-11 hours
... In adults with normal renal and hepatic function, the half-life of etoposide averages 0.6-2 hours ... in the initial phase and 5.3-10.8 hours ... in the terminal phase. In one adult with impaired hepatic function, the terminal elimination half-life was reportedly 78 hours. In children with normal renal and hepatic function, the half-life of etoposide averages 0.6-1.4 hours in the initial phase and 3-5.8 hours in the terminal phase.
... Elimination half-life of 3 to 7 hr in children and 4 to 8 hr in adults.
Toxicity/Toxicokinetics
Toxicity Summary
Etoposide inhibits DNA topoisomerase II, thereby inhibiting DNA re-ligation. This causes critical errors in DNA synthesis at the premitotic stage of cell division and can lead to apoptosis of the cancer cell. Etoposide is cell cycle dependent and phase specific, affecting mainly the S and G2 phases of cell division. Inhibition of the topoisomerase II alpha isoform results in the anti-tumour activity of etoposide. The drug is also capable of inhibiting the beta isoform but inhibition of this target is not associated with the anti-tumour activity. It is instead associated with the carcinogenic effect.
Effects During Pregnancy and Lactation
◉ Summary of Use during Lactation
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy. It might be possible to breastfeed safely during intermittent therapy with etoposide after an appropriate period of breastfeeding abstinence. A period of at least 24 hours is required after a dose of 80 mg/sq. m. or less. Others have suggested an abstinence period of 72 hours after etoposide use. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk. Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.
◉ Effects in Breastfed Infants
One mother received with 5 daily doses of etoposide 80 mg/sq. m. and cytarabine 170 mg/sq. m. intravenously as well as 3 daily doses of 6 mg/sq. m. of mitoxantrone intravenously. She resumed breastfeeding her infant 3 weeks after the third dose of mitoxantrone at a time when mitoxantrone was still detectable in milk. The infant had no apparent abnormalities at 16 months of age.
◉ Effects on Lactation and Breastmilk
A telephone follow-up study was conducted on 74 women who received cancer chemotherapy at one center during the second or third trimester of pregnancy to determine if they were successful at breastfeeding postpartum. Only 34% of the women were able to exclusively breastfeed their infants, and 66% of the women reported experiencing breastfeeding difficulties. This was in comparison to a 91% breastfeeding success rate in 22 other mothers diagnosed during pregnancy, but not treated with chemotherapy. Other statistically significant correlations included: 1. mothers with breastfeeding difficulties had an average of 5.5 cycles of chemotherapy compared with 3.8 cycles among mothers who had no difficulties; and 2. mothers with breastfeeding difficulties received their first cycle of chemotherapy on average 3.4 weeks earlier in pregnancy. Of the 9 women who received a taxane-containing regimen, 7 had breastfeeding difficulties.
Protein Binding
97% protein bound.
Interactions
Additive bone marrow depression may occur; dosage reduction may be required when two or more bone marrow depressants, including radiation, are used concurrently or consecutively.
Multidrug resistance is one of the mechanisms of resistance to multiple cytotoxic drugs and is mediated by the expression of a membrane pump called the P-glycoprotein. Nifedipine is one of the calcium channel blocking agents which reverses multidrug resistance in vitro. Fifteen patients with various malignancies received nifedipine at three dose levels: 40 mg, 60 mg and 80 mg orally twice daily for 6 days. Etoposide was administered intravenously on day 2 in a dose of 150-250 mg/sq m and orally 150-300 mg twice daily on days 3 and 4. Cardiovascular effects of nifedipine were dose limiting and the maximum tolerated dose was 60 mg twice a day. Mean area under the plasma concentration curve and plasma half-life of nifedipine and its major metabolite MI at the highest dose level were 7.87 uM.hr, 7.97 hr and 4.97 uM.hr, 14.0 hr respectively. Nifedipine did not interfere with the pharmacokinetics of etoposide.
Dipyridamole has chemical characteristics similar to other known modulators of etoposide, doxorubicin, and vinblastine sensitivity. When compared to verapamil, dipyridamole was as efficacious but twice as potent in its synergistic enhancement of etoposide sensitivity. These results demonstrate that dipyridamole can markedly increase the cytotoxicity of etoposide, doxorubicin, and vinblastine and suggest possible clinical applications.
Enhanced antineoplastic action of etoposide in the presence of cyclosporin A, was investigated in several in vitro and in vivo tumor systems. Macromolecular DNA damage induced by etoposide at drug levels comparable to plasma area under the curve values achieved in patients was increased not only in leukemic peripheral blood cells from patients but also in mononuclear peripheral blood cells from a healthy donor. Intracellular retention of radioactivity from (3)H etoposide was increased by a factor of 1.5 at the most in the presence of cyclosporin A. The cytotoxicity of etoposide and adriamycin to L 1210 leukemic cells was clearly enhanced, whereas cyclosporin A had no effect on the action of cisplatin or ionizing irradiation. At cyclosporin A blood levels not exceeding 1.44 ug/ml, increased tumor inhibition of etoposide was observed in a human embryonal cancer xenograft, but there was also higher lethality in normal mice. With respect to chemosensitization the effects of cyclosporin A resemble those of calcium channel blockers or anticalmodulin agents. In contrast to calcium channel blockers, however, adequate plasma levels of cyclosporin A can well be achieved in patients.
For more Interactions (Complete) data for ETOPOSIDE (7 total), please visit the HSDB record page.
Non-Human Toxicity Values
LD50 Mouse IV 118 mg/kg bw
LD50 Rat IV 68 mg/kg bw
LD50 Rabbit IV > 80 mg/kg bw
LD50 Mouse ip 108 mg/kg bw
References

[1]. J Natl Cancer Inst . 1988 Dec 7;80(19):1526-33.

[2]. J Dermatol Sci . 2000 Nov;24(2):126-33.

[3]. Cancer Res . 1983 Apr;43(4):1592-7.

[4]. Cancer Chemother Pharmacol . 2001 Oct;48(4):327-32.

[5]. Cancer Chemother Pharmacol . 1998;41(2):93-7.

[6]. Cancer . 1998 Dec 1;83(11):2400-7.

[7]. Gan To Kagaku Ryoho . 1991 Jun;18(7):1155-61.

[8]. J Surg Oncol . 1993 Dec;54(4):211-5.

[9]. Cancer Chemother Pharmacol . 2001 Oct;48(4):327-32.

Additional Infomation
Therapeutic Uses
Antineoplastic Agents, Phytogenic; Nucleic Acid Synthesis Inhibitors
Etoposide injection is indicated, in combination with other antineoplastics, for first-line treatment of testicular tumors (Evidence rating: 1A). /Included in US product labeling/
Etoposide is indicated in combination with other agents as first-line treatment of small cell lung carcinoma. /Included in US product labeling/
Etoposide also is indicated, alone and in combination with other agents, for treatment of Hodgkin's and non-Hodgkin"s lymphomas and acute nonlymphocytic (myelocytic) leukemia. /NOT included in US product labeling/
For more Therapeutic Uses (Complete) data for ETOPOSIDE (13 total), please visit the HSDB record page.
Drug Warnings
The major and dose-limiting adverse effect of etoposide is hematologic toxicity. Myelosuppression, which is dose related, is manifested mainly by leukopenia (principally granulocytopenia). Myelosuppression resulting in death has been reported in patients receiving etoposide. Thrombocytopenia occurs less frequently, and anemia may also occur; pancytopenia has occurred in some patients. Myelosuppression apparently is not cumulative but may be more severe in patients previously treated with other antineoplastic agents or radiation therapy. Leukopenia has reportedly occurred in 60-91% of patients receiving etoposide and was severe (leukocyte count less than 1000/cu mm) in 3-17% of patients. Neutropenia (less than 2000 cu mm) occurred in 88% of patients treated with etoposide phosphate; severe neutropenia has reportedly occurred in 22-41% of patients receiving the drug and was severe (platelet count less than 50,000/cu mm) in 1-20% of patients. Anemia has occurred in up to 33% of patients receiving etoposide. Anemia (hemoglobin less than 11 g/dL) occurred in 72% of patients treated with etoposide phosphate; severe anemia (hemoglobin less than 8 g/dL) occurred in 19% of patients treated. Granulocyte and platelet nadirs usually occur within 7-14 and 9-16 days, respectively, after administration of etoposide, and within 12-19 and 10-15 days, respectively, after administration of etoposide phosphate; leukocyte nadir has been reported to occur within 15-22 days after administration of etoposide, phosphate. Bone marrow recovery is usually complete within 20 days after administration, but may occasionally require longer periods. Fever and infection have been reported in patients with drug-induced neutropenia.
Pregnancy risk category: D /POSITIVE EVIDENCE OF RISK. Studies in humans, or investigational or post-marketing data, have demonstrated fetal risk. Nevertheless, potential benefits from the use of the drug may outweigh the potential risk. For example, the drug may be acceptable if needed in a life-threatening situation or serious disease for which safer drugs cannot be used or are ineffective./
Reversible alopecia, sometimes progressing to complete baldness, has occurred in 8-66% of patients receiving etoposide. The degree of alopecia may be dose related. Stevens-Johnson syndrome has been reported infrequently in patients receiving etoposide. Rash, pigmentation, urticaria, and severe pruritus have occurred infrequently, and cutaneous radiation-recall reactions associated with etoposide have been reported. ...
Anaphylactoid reactions consisting principally of chills, rigors, diaphoresis, pruritus, loss of consciousness, nausea, vomiting, fever, bronchospasm, dyspnea, tachycardia, hypertension, and/or hypotension have occurred during or immediately after administration of etoposide or etoposide phosphate in 0.7-3% of patients receiving the drug. Other manifestations have included flushing, rash, substernal chest pain, lacrimation, sneezing, coryza, throat pain, back pain, generalized body pain, abdominal cramps, and auditory impairment.
For more Drug Warnings (Complete) data for ETOPOSIDE (24 total), please visit the HSDB record page.
Pharmacodynamics
Etoposide is an antineoplastic agent and an epipodophyllotoxin (a semisynthetic derivative of the podophyllotoxins). It inhibits DNA topoisomerase II, thereby ultimately inhibiting DNA synthesis. Etoposide is cell cycle dependent and phase specific, affecting mainly the S and G2 phases. Two different dose-dependent responses are seen. At high concentrations (10 µg/mL or more), lysis of cells entering mitosis is observed. At low concentrations (0.3 to 10 µg/mL), cells are inhibited from entering prophase. It does not interfere with microtubular assembly. The predominant macromolecular effect of etoposide appears to be the induction of DNA strand breaks by an interaction with DNA-topoisomerase II or the formation of free radicals.
These protocols are for reference only. InvivoChem does not independently validate these methods.
Physicochemical Properties
Molecular Formula
C29H32O13
Molecular Weight
588.56
Exact Mass
588.184
Elemental Analysis
C, 59.18; H, 5.48; O, 35.34
CAS #
33419-42-0
Related CAS #
117091-64-2
PubChem CID
36462
Appearance
White to off-white solid powder
Density
1.6±0.1 g/cm3
Boiling Point
798.1±60.0 °C at 760 mmHg
Melting Point
236-251ºC
Flash Point
263.6±26.4 °C
Vapour Pressure
0.0±3.0 mmHg at 25°C
Index of Refraction
1.662
LogP
0.3
Hydrogen Bond Donor Count
3
Hydrogen Bond Acceptor Count
13
Rotatable Bond Count
5
Heavy Atom Count
42
Complexity
969
Defined Atom Stereocenter Count
10
SMILES
O=C1OC[C@]2([H])[C@H](O[C@H]3[C@@H]([C@H]([C@@H]4O[C@H](C)OC[C@H]4O3)O)O)C5=C(C=C6OCOC6=C5)[C@@H](C7=CC(OC)=C(O)C(OC)=C7)[C@]21[H]
InChi Key
VJJPUSNTGOMMGY-MRVIYFEKSA-N
InChi Code
InChI=1S/C29H32O13/c1-11-36-9-20-27(40-11)24(31)25(32)29(41-20)42-26-14-7-17-16(38-10-39-17)6-13(14)21(22-15(26)8-37-28(22)33)12-4-18(34-2)23(30)19(5-12)35-3/h4-7,11,15,20-22,24-27,29-32H,8-10H2,1-3H3/t11-,15+,20-,21-,22+,24-,25-,26-,27-,29+/m1/s1
Chemical Name
(5S,5aR,8aR,9R)-5-[[(2R,4aR,6R,7R,8R,8aS)-7,8-dihydroxy-2-methyl-4,4a,6,7,8,8a-hexahydropyrano[3,2-d][1,3]dioxin-6-yl]oxy]-9-(4-hydroxy-3,5-dimethoxyphenyl)-5a,6,8a,9-tetrahydro-5H-[2]benzofuro[6,5-f][1,3]benzodioxol-8-one
Synonyms
Demethyl Epipodophyllotoxin; Ethylidine Glucoside; epipodophyllotoxin; trans-Etoposide; (-)-Etoposide; Lastet; Zuyeyidal; US brand names: Toposar; VePesid. Foreign brand name: Lastet. Abbreviation: EPEG Code names: VP16; VP16213;
HS Tariff Code
2934.99.9001
Storage

Powder      -20°C    3 years

                     4°C     2 years

In solvent   -80°C    6 months

                  -20°C    1 month

Note: This product requires protection from light (avoid light exposure) during transportation and storage.
Shipping Condition
Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)
Solubility Data
Solubility (In Vitro)
DMSO: ~100 mg/mL (~169.9 mM)
Water: <1 mg/mL
Ethanol: <1 mg/mL
Solubility (In Vivo)
Solubility in Formulation 1: ≥ 2.5 mg/mL (4.25 mM) (saturation unknown) in 10% DMSO + 40% PEG300 + 5% Tween80 + 45% Saline (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 25.0 mg/mL clear DMSO stock solution to 400 μL PEG300 and mix evenly; then add 50 μL Tween-80 to the above solution and mix evenly; then add 450 μL normal saline to adjust the volume to 1 mL.
Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH₂ O to obtain a clear solution.

Solubility in Formulation 2: ≥ 2.5 mg/mL (4.25 mM) (saturation unknown) in 10% DMSO + 90% Corn Oil (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 25.0 mg/mL clear DMSO stock solution to 900 μL of corn oil and mix evenly.

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Solubility in Formulation 3: ≥ 2.5 mg/mL (4.25 mM) (saturation unknown) in 5% DMSO + 40% PEG300 + 5% Tween80 + 50% Saline (add these co-solvents sequentially from left to right, and one by one), clear solution.
Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH₂ O to obtain a clear solution.


Solubility in Formulation 4: ≥ 2.5 mg/mL (4.25 mM) (saturation unknown) in 5% DMSO + 95% (20% SBE-β-CD in Saline) (add these co-solvents sequentially from left to right, and one by one), clear solution.
Preparation of 20% SBE-β-CD in Saline (4°C,1 week): Dissolve 2 g SBE-β-CD in 10 mL saline to obtain a clear solution.

Solubility in Formulation 5: ≥ 0.5 mg/mL (0.85 mM) (saturation unknown) in 1% DMSO 99% Saline (add these co-solvents sequentially from left to right, and one by one), clear solution.
Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH₂ O to obtain a clear solution.

Solubility in Formulation 6: 30% Propylene glycol , 5% Tween 80 , 65% D5W: 30 mg/mL

 (Please use freshly prepared in vivo formulations for optimal results.)
Preparing Stock Solutions 1 mg 5 mg 10 mg
1 mM 1.6991 mL 8.4953 mL 16.9906 mL
5 mM 0.3398 mL 1.6991 mL 3.3981 mL
10 mM 0.1699 mL 0.8495 mL 1.6991 mL

*Note: Please select an appropriate solvent for the preparation of stock solution based on your experiment needs. For most products, DMSO can be used for preparing stock solutions (e.g. 5 mM, 10 mM, or 20 mM concentration); some products with high aqueous solubility may be dissolved in water directly. Solubility information is available at the above Solubility Data section. Once the stock solution is prepared, aliquot it to routine usage volumes and store at -20°C or -80°C. Avoid repeated freeze and thaw cycles.

Calculator

Molarity Calculator allows you to calculate the mass, volume, and/or concentration required for a solution, as detailed below:

  • Calculate the Mass of a compound required to prepare a solution of known volume and concentration
  • Calculate the Volume of solution required to dissolve a compound of known mass to a desired concentration
  • Calculate the Concentration of a solution resulting from a known mass of compound in a specific volume
An example of molarity calculation using the molarity calculator is shown below:
What is the mass of compound required to make a 10 mM stock solution in 5 ml of DMSO given that the molecular weight of the compound is 350.26 g/mol?
  • Enter 350.26 in the Molecular Weight (MW) box
  • Enter 10 in the Concentration box and choose the correct unit (mM)
  • Enter 5 in the Volume box and choose the correct unit (mL)
  • Click the “Calculate” button
  • The answer of 17.513 mg appears in the Mass box. In a similar way, you may calculate the volume and concentration.

Dilution Calculator allows you to calculate how to dilute a stock solution of known concentrations. For example, you may Enter C1, C2 & V2 to calculate V1, as detailed below:

What volume of a given 10 mM stock solution is required to make 25 ml of a 25 μM solution?
Using the equation C1V1 = C2V2, where C1=10 mM, C2=25 μM, V2=25 ml and V1 is the unknown:
  • Enter 10 into the Concentration (Start) box and choose the correct unit (mM)
  • Enter 25 into the Concentration (End) box and select the correct unit (mM)
  • Enter 25 into the Volume (End) box and choose the correct unit (mL)
  • Click the “Calculate” button
  • The answer of 62.5 μL (0.1 ml) appears in the Volume (Start) box
g/mol

Molecular Weight Calculator allows you to calculate the molar mass and elemental composition of a compound, as detailed below:

Note: Chemical formula is case sensitive: C12H18N3O4  c12h18n3o4
Instructions to calculate molar mass (molecular weight) of a chemical compound:
  • To calculate molar mass of a chemical compound, please enter the chemical/molecular formula and click the “Calculate’ button.
Definitions of molecular mass, molecular weight, molar mass and molar weight:
  • Molecular mass (or molecular weight) is the mass of one molecule of a substance and is expressed in the unified atomic mass units (u). (1 u is equal to 1/12 the mass of one atom of carbon-12)
  • Molar mass (molar weight) is the mass of one mole of a substance and is expressed in g/mol.
/

Reconstitution Calculator allows you to calculate the volume of solvent required to reconstitute your vial.

  • Enter the mass of the reagent and the desired reconstitution concentration as well as the correct units
  • Click the “Calculate” button
  • The answer appears in the Volume (to add to vial) box
In vivo Formulation Calculator (Clear solution)
Step 1: Enter information below (Recommended: An additional animal to make allowance for loss during the experiment)
Step 2: Enter in vivo formulation (This is only a calculator, not the exact formulation for a specific product. Please contact us first if there is no in vivo formulation in the solubility section.)
+
+
+

Calculation results

Working concentration mg/mL;

Method for preparing DMSO stock solution mg drug pre-dissolved in μL DMSO (stock solution concentration mg/mL). Please contact us first if the concentration exceeds the DMSO solubility of the batch of drug.

Method for preparing in vivo formulation:Take μL DMSO stock solution, next add μL PEG300, mix and clarify, next addμL Tween 80, mix and clarify, next add μL ddH2O,mix and clarify.

(1) Please be sure that the solution is clear before the addition of next solvent. Dissolution methods like vortex, ultrasound or warming and heat may be used to aid dissolving.
             (2) Be sure to add the solvent(s) in order.

Clinical Trial Information
Study of Pembrolizumab/Vibostolimab (MK-7684A) in Combination With Concurrent Chemoradiotherapy Followed by Pembrolizumab/Vibostolimab Versus Concurrent Chemoradiotherapy Followed by Durvalumab in Participants With Stage III Non-small Cell Lung Cancer (MK-7684A-006/KEYVIBE-006)
CTID: NCT05298423
Phase: Phase 3    Status: Recruiting
Date: 2024-12-02
A Study of N9 Chemotherapy in Children With Neuroblastoma
CTID: NCT04947501
PhaseEarly Phase 1    Status: Active, not recruiting
Date: 2024-12-02
Study of Pembrolizumab (MK-3475) Combination Therapies in Metastatic Castration-Resistant Prostate Cancer (MK-3475-365/KEYNOTE-365)
CTID: NCT02861573
Phase: Phase 1/Phase 2    Status: Recruiting
Date: 2024-12-02
A UGT1A1 Genotype-Directed Study of Belinostat Pharmacokinetics and Toxicity
CTID: NCT06406465
Phase: Phase 2    Status: Not yet recruiting
Date: 2024-12-02
Safety and Effectiveness of BNT327, an Investigational Therapy in Combination With Chemotherapy for Patients With Untreated Small-cell Lung Cancer
CTID: NCT06712355
Phase: Phase 3    Status: Not yet recruiting
Date: 2024-12-02
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A Study to Compare Standard Therapy to Treat Hodgkin Lymphoma to the Use of Two Drugs, Brentuximab Vedotin and Nivolumab
CTID: NCT05675410
Phase: Phase 3    Status: Recruiting
Date: 2024-12-02


Dinutuximab With Chemotherapy, Surgery and Stem Cell Transplantation for the Treatment of Children With Newly Diagnosed High Risk Neuroblastoma
CTID: NCT06172296
Phase: Phase 3    Status: Recruiting
Date: 2024-12-02
Testing the Addition of High Dose, Targeted Radiation to the Usual Treatment for Locally-Advanced Inoperable Non-small Cell Lung Cancer
CTID: NCT05624996
Phase: Phase 3    Status: Recruiting
Date: 2024-11-29
Study of Ociperlimab (BGB-A1217) in Combination With Tislelizumab in Advanced Solid Tumors
CTID: NCT04047862
Phase: Phase 1    Status: Completed
Date: 2024-11-29
Debio 0123 in Combination With Carboplatin and Etoposide in Adult Participants With Small Cell Lung Cancer That Recurred or Progressed After Previous Standard Platinum-Based Therapy
CTID: NCT05815160
Phase: Phase 1    Status: Recruiting
Date: 2024-11-29
Pembrolizumab and Concurrent Chemoradiotherapy or Radiation Therapy in Treating Patients With Small Cell Lung Cancer
CTID: NCT02402920
Phase: Phase 1    Status: Active, not recruiting
Date: 2024-11-29
Pomalidomide and Dose-Adjusted EPOCH +/- Rituximab for HIV-Associated Lymphomas
CTID: NCT05389423
Phase: Phase 1    Status: Suspended
Date: 2024-11-27
Treatment of Acute Lymphoblastic Leukemia in Children
CTID: NCT00400946
Phase: Phase 3    Status: Completed
Date: 2024-11-27
Trial Treating Relapsed Acute Lymphoblastic Leukemia With Venetoclax and Navitoclax
CTID: NCT05192889
Phase: Phase 1/Phase 2    Status: Active, not recruiting
Date: 2024-11-26
DAREONᵀᴹ-8: A Study to Test How Well Different Doses of BI 764532 in Addition to Standard of Care Are Tolerated by People With Advanced Small Cell Lung Cancer
CTID: NCT06077500
Phase: Phase 1    Status: Recruiting
Date: 2024-11-26
A Trial With Chemotherapy, Immunotherapy, and Radiotherapy for Patients With Newly Diagnosed Stage IV Small Cell Lung Cancer
CTID: NCT04951115
Phase: Phase 2    Status: Terminated
Date: 2024-11-26
Total Therapy XVII for Newly Diagnosed Patients With Acute Lymphoblastic Leukemia and Lymphoma
CTID: NCT03117751
Phase: Phase 2/Phase 3    Status: Active, not recruiting
Date: 2024-11-26
Virotherapy and Natural History Study of KHSV-Associated Multricentric Castleman s Disease With Correlates of Disease Activity
CTID: NCT00092222
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-25
A Trial to Learn How Effective and Safe Odronextamab is Compared to Standard of Care for Adult Participants With Previously Treated Aggressive B-cell Non-Hodgkin Lymphoma
CTID: NCT06230224
Phase: Phase 3    Status: Recruiting
Date: 2024-11-25
Testing the Safety and Efficacy of the Addition of A New Anti-cancer Drug, ZEN003694, to Chemotherapy Treatment (Etoposide and Cisplatin) for Adult and Pediatric Patients (12-17 Years) With NUT Carcinoma
CTID: NCT05019716
Phase: Phase 1/Phase 2    Status: Recruiting
Date: 2024-11-25
Pembrolizumab/Vibostolimab (MK-7684A) or Atezolizumab in Combination With Chemotherapy in First Line Treatment of Extensive-Stage Small Cell Lung Cancer (MK-7684A-008, KEYVIBE-008)
CTID: NCT05224141
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-25
Safety, Preliminary Effectiveness of BNT327, an Investigational Therapy for Patients With Small-cell Lung Cancer in Combination With Chemotherapy
CTID: NCT06449209
Phase: Phase 2    Status: Recruiting
Date: 2024-11-25
A Study of PT217 in Patients with Neuroendocrine Carcinomas Expressing DLL3 (the SKYBRIDGE Study)
CTID: NCT05652686
Phase: Phase 1/Phase 2    Status: Recruiting
Date: 2024-11-22
Adcetris (Brentuximab Vedotin), Combination Chemotherapy, and Radiation Therapy in Treating Younger Patients With Stage IIB, IIIB and IV Hodgkin Lymphoma
CTID: NCT01920932
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-21
Atovaquone (Mepron®) Combined with Conventional Chemotherapy for De Novo Acute Myeloid Leukemia (AML)
CTID: NCT03568994
PhaseEarly Phase 1    Status: Active, not recruiting
Date: 2024-11-21
Evaluating the Addition of the Immunotherapy Drug Atezolizumab to Standard Chemotherapy Treatment for Advanced or Metastatic Neuroendocrine Carcinomas That Originate Outside the Lung
CTID: NCT05058651
Phase: Phase 2/Phase 3    Status: Recruiting
Date: 2024-11-21
Safety and Efficacy of Pembrolizumab (MK-3475) in Children and Young Adults With Classical Hodgkin Lymphoma (MK-3475-667/KEYNOTE-667)
CTID: NCT03407144
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-20
Immunotherapy in Combination With Chemoradiation in Patients With Advanced Solid Tumors
CTID: NCT03509012
Phase: Phase 1    Status: Active, not recruiting
Date: 2024-11-20
N10: A Study of Reduced Chemotherapy and Monoclonal Antibody (mAb)-Based Therapy in Children With Neuroblastoma
CTID: NCT06528496
Phase: Phase 2    Status: Recruiting
Date: 2024-11-20
Study of Safety and Efficacy of Pembrolizumab and Chemotherapy in Participants With Newly Diagnosed Classical Hodgkin Lymphoma (cHL) (MK-3475-C11/KEYNOTE-C11)
CTID: NCT05008224
Phase: Phase 2    Status: Completed
Date: 2024-11-20
DAREON™-7: A Study to Test How Well Different Doses of BI 764532 in Addition to Chemotherapy Are Tolerated by People With Advanced Neuroendocrine Cancers
CTID: NCT06132113
Phase: Phase 1    Status: Recruiting
Date: 2024-11-20
Placebo-controlled, Study of Concurrent Chemoradiation Therapy With Pembrolizumab Followed by Pembrolizumab and Olaparib in Newly Diagnosed Treatment-Naïve Limited-Stage Small Cell Lung Cancer (LS-SCLC) (MK 7339-013/KEYLYNK-013)
CTID: NCT04624204
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-19
Efficacy and Safety of Pembrolizumab Plus Investigational Agents in Combination With Chemotherapy as First-Line Treatment in Extensive-Stage Small Cell Lung Cancer (ES-SCLC) (MK-3475-B99/ KEYNOTE-B99)
CTID: NCT04924101
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-19
Chemotherapy Followed by Radiation Therapy in Treating Younger Patients With Newly Diagnosed Localized Central Nervous System Germ Cell Tumors
CTID: NCT01602666
Phase: Phase 2    Status: Completed
Date: 2024-11-19
Study of Pembrolizumab With Concurrent Chemoradiation Therapy Followed by Pembrolizumab With or Without Olaparib in Stage III Non-Small Cell Lung Cancer (NSCLC) (MK-7339-012/KEYLYNK-012)
CTID: NCT04380636
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-19
A Phase III, Randomised Study of Adjuvant Dato-DXd in Combination With Rilvegostomig or Rilvegostomig Monotherapy Versus Standard of Care, Following Complete Tumour Resection, in Participants With Stage I Adenocarcinoma NSCLC Who Are ctDNA-positive or Have High-risk Pathological Features
CTID: NCT06564844
Phase: Phase 3    Status: Recruiting
Date: 2024-11-18
A Study to Evaluate Glofitamab Monotherapy and Glofitamab + Chemoimmunotherapy in Pediatric and Young Adult Participants With Relapsed/Refractory Mature B-Cell Non-Hodgkin Lymphoma
CTID: NCT05533775
Phase: Phase 1/Phase 2    Status: Recruiting
Date: 2024-11-18
Tazemetostat Plus CHOP in 1L T-cell Lymphoma
CTID: NCT06692452
Phase: Phase 2    Status: Not yet recruiting
Date: 2024-11-18
Donor Natural Killer Cells, Cyclophosphamide, and Etoposide in Treating Children and Young Adults With Relapsed or Refractory Solid Tumors
CTID: NCT03420963
Phase: Phase 1    Status: Recruiting
Date: 2024-11-18
Tafasitamab and Lenalidomide Followed by Tafasitamab and ICE As Salvage Therapy for Transplant Eligible Patients with Relapsed/ Refractory Large B-Cell Lymphoma
CTID: NCT05821088
Phase: Phase 2    Status: Recruiting
Date: 2024-11-15
Ibrutinib Before and After Stem Cell Transplant in Treating Patients With Relapsed or Refractory Diffuse Large B-cell Lymphoma
CTID: NCT02443077
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-14
A Study to Compare the Efficacy and Safety of BMS-986489 (BMS-986012+ Nivolumab Fixed Dose Combination) in Combination With Carboplatin Plus Etoposide to That of Atezolizumab With Carboplatin Plus Etoposide as First-Line Therapy in Participants With Extensive-Stage Small Cell Lung Cancer (TIGOS).
CTID: NCT06646276
Phase: Phase 3    Status: Not yet recruiting
Date: 2024-11-14
A Clinical Trial of LBL-024 Combined With Etoposide and Platinum in Patients With Advanced Neuroendocrine Carcinoma
CTID: NCT06157827
Phase: Phase 1/Phase 2    Status: Recruiting
Date: 2024-11-14
Combination Chemotherapy With or Without Donor Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia
CTID: NCT00792948
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-13
Brentuximab Vedotin and Combination Chemotherapy in Treating Children and Young Adults With Stage IIB, Stage IIIB, IVA, or IVB Hodgkin Lymphoma
CTID: NCT02166463
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-13
Combination Chemotherapy With or Without Bortezomib in Treating Younger Patients With Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia or Stage II-IV T-Cell Lymphoblastic Lymphoma
CTID: NCT02112916
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-13
Combination Chemotherapy in Treating Young Patients With Newly Diagnosed High-Risk B Acute Lymphoblastic Leukemia and Ph-Like TKI Sensitive Mutations
CTID: NCT02883049
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-13
Cisplatin/Carboplatin and Etoposide With or Without Nivolumab in Treating Patients With Extensive Stage Small Cell Lung Cancer
CTID: NCT03382561
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-13
Blinatumomab in Treating Younger Patients With Relapsed B-cell Acute Lymphoblastic Leukemia
CTID: NCT02101853
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-13
Sirolimus in Combination With Metronomic Chemotherapy in Children With High-Risk Solid Tumors
CTID: NCT04469530
Phase: Phase 2    Status: Recruiting
Date: 2024-11-13
Testing the Addition of a New Anti-cancer Drug, Venetoclax, to Usual Chemotherapy for High Grade B-cell Lymphomas
CTID: NCT03984448
Phase: Phase 2/Phase 3    Status: Active, not recruiting
Date: 2024-11-12
Safety and Efficacy of SYHA1813 Single Agent or in Combination With Different Regimens in Unresectable Locally Advanced or Metastatic Solid Tumors.
CTID: NCT06682611
Phase: Phase 1/Phase 2    Status: Not yet recruiting
Date: 2024-11-12
Testing the Addition of an Antibody to Standard Chemoradiation Followed by the Antibody for One Year to Standard Chemoradiation Followed by One Year of the Antibody in Patients With Unresectable Stage III Non-Small Cell Lung Cancer
CTID: NCT04092283
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-12
Testing the Addition of a New Immunotherapy Drug, Atezolizumab (MPDL3280A), to the Usual Chemoradiation (CRT) Therapy Treatment for Limited Stage Small Cell Lung Cancer (LS-SCLC)
CTID: NCT03811002
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-12
Ibrutinib, Rituximab, Etoposide, Prednisone, Vincristine Sulfate, Cyclophosphamide, and Doxorubicin Hydrochloride in Treating Patients With HIV-Positive Stage II-IV Diffuse Large B-Cell Lymphomas
CTID: NCT03220022
Phase: Phase 1    Status: Recruiting
Date: 2024-11-12
Irinotecan and Temozolomide in Combination With Existing High Dose Alkylator Based Chemotherapy for Treatment of Patients With Newly Diagnosed Ewing Sarcoma
CTID: NCT01864109
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-12
Maintenance Oral Etoposide or Observation Following High-dose Chemo for GCT
CTID: NCT04804007
Phase: Phase 2    Status: Recruiting
Date: 2024-11-12
Combination Chemotherapy, Radiation Therapy, and Bevacizumab in Treating Patients With Newly Diagnosed Stage III Non-small Cell Lung Cancer That Cannot Be Removed by Surgery
CTID: NCT00334815
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-08
A Global Study of Novel Agents in Paediatric and Adolescent Relapsed and Refractory B-cell Non-Hodgkin Lymphoma
CTID: NCT05991388
Phase: Phase 2/Phase 3    Status: Recruiting
Date: 2024-11-08
Safety and Efficacy of Quizartinib in Children and Young Adults With Acute Myeloid Leukemia (AML), a Cancer of the Blood
CTID: NCT03793478
Phase: Phase 1/Phase 2    Status: Active, not recruiting
Date: 2024-11-07
Response-Based Chemotherapy in Treating Newly Diagnosed Acute Myeloid Leukemia or Myelodysplastic Syndrome in Younger Patients With Down Syndrome
CTID: NCT02521493
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-07
Study to Compare Axicabtagene Ciloleucel With Standard of Care Therapy as First-line Treatment in Participants With High-risk Large B-cell Lymphoma
CTID: NCT05605899
Phase: Phase 3    Status: Recruiting
Date: 2024-11-05
Entrectinib as a Single Agent in Upfront Therapy for Children <3 Years of Age With NTRK1/2/3 or ROS1-FUSED CNS Tumors
CTID: NCT06528691
Phase: Phase 2    Status: Recruiting
Date: 2024-11-04
Nivolumab With DA-REPOCH Chemotherapy Regimen in Treating Patients With Aggressive B-Cell Non-Hodgkin's Lymphoma
CTID: NCT03749018
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-04
Auto Stem Cell Transplant for Lymphoma Patients
CTID: NCT03125642
Phase: Phase 2    Status: Recruiting
Date: 2024-11-04
Irinotecan and Carboplatin as Upfront Window Therapy in Treating Patients With Newly Diagnosed Intermediate-Risk or High-Risk Rhabdomyosarcoma
CTID: NCT00077285
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-11-04
Response and Biology-Based Risk Factor-Guided Therapy in Treating Younger Patients With Non-high Risk Neuroblastoma
CTID: NCT02176967
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-11-01
Using MRI-Guided Laser Heat Ablation to Induce Disruption of the Peritumoral Blood Brain Barrier to Enhance Delivery and Efficacy of Treatment of Pediatric Brain Tumors
CTID: NCT02372409
Phase: Phase 2    Status: Terminated
Date: 2024-11-01
Polatuzumab Vedotin in Combination With Chemotherapy in Subjects With Richter's Transformation
CTID: NCT04679012
Phase: Phase 2    Status: Recruiting
Date: 2024-10-31
Phase 2 Study of Alisertib Therapy for Rhabdoid Tumors
CTID: NCT02114229
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-10-31
A Study of Lower Radiotherapy Dose to Treat Children With CNS Germinoma
CTID: NCT06368817
Phase: Phase 2    Status: Recruiting
Date: 2024-10-31
LB-100, Carboplatin, Etoposide, and Atezolizumab for the Treatment of Untreated Extensive-Stage Small Cell Lung Cancer
CTID: NCT04560972
Phase: Phase 1    Status: Active, not recruiting
Date: 2024-10-30
A Phase III, Open-Label Study of Maintenance Lurbinectedin in Combination With Atezolizumab Compared With Atezolizumab in Participants With Extensive-Stage Small-Cell Lung Cancer
CTID: NCT05091567
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-29
Nivolumab With Standard of Care Chemotherapy for Peripheral T Cell Lymphomas
CTID: NCT03586999
Phase: Phase 1/Phase 2    Status: Completed
Date: 2024-10-29
Atezolizumab and Rechallenge Chemotherapy in Relapsed Patients With Extensive-stage Small Cell Lung Cancer (ES-SCLC).
CTID: NCT06663098
Phase: Phase 2    Status: Not yet recruiting
Date: 2024-10-29
Molecular and Clinical Risk-Directed Therapy for Infants and Young Children With Newly Diagnosed Medulloblastoma
CTID: NCT05535166
Phase: Phase 2    Status: Recruiting
Date: 2024-10-29
Chemo-Immunotherapy Followed by Durvalumab and Ceralasertib in Treatment Naïve Patients With Extensive Stage Small Cell Lung Cancer
CTID: NCT04699838
Phase: Phase 2    Status: Recruiting
Date: 2024-10-26
Active Surveillance, Bleomycin, Etoposide, Carboplatin or Cisplatin in Treating Pediatric and Adult Patients With Germ Cell Tumors
CTID: NCT03067181
Phase: Phase 3    Status: Recruiting
Date: 2024-10-26
Chemotherapy and Donor Stem Transplant for the Treatment of Patients With High Grade Brain Cancer
CTID: NCT04521946
Phase: Phase 1    Status: Withdrawn
Date: 2024-10-26
Donor Stem Cell Transplant After Chemotherapy for the Treatment of Recurrent or Refractory High-Risk Solid Tumors in Pediatric and Adolescent-Young Adults
CTID: NCT04530487
Phase: Phase 2    Status: Terminated
Date: 2024-10-26
A Study of a New Way to Treat Children and Young Adults With a Brain Tumor Called NGGCT
CTID: NCT04684368
Phase: Phase 2    Status: Recruiting
Date: 2024-10-26
Maintenance Chemotherapy or Observation Following Induction Chemotherapy and Radiation Therapy in Treating Patients With Newly Diagnosed Ependymoma
CTID: NCT01096368
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-26
A Study to Give Treatment Inside the Eye to Treat Retinoblastoma
CTID: NCT05504291
Phase: Phase 2    Status: Recruiting
Date: 2024-10-26
A Study of Combination Chemotherapy for Patients With Newly Diagnosed DAWT and Relapsed FHWT
CTID: NCT04322318
Phase: Phase 2    Status: Recruiting
Date: 2024-10-26
Anti-PD-1 in Combination With Chemotherapy as First-Line Treatment to Lung Cancer
CTID: NCT03432598
Phase: Phase 2    Status: Completed
Date: 2024-10-23
Durvalumab ± Tremelimumab in Combination With Platinum Based Chemotherapy in Untreated Extensive-Stage Small Cell Lung Cancer (CASPIAN)
CTID: NCT03043872
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-23
Bortezomib and Sorafenib Tosylate in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia
CTID: NCT01371981
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-22
A Study to Compare Standard Chemotherapy to Therapy With CPX-351 and/or Gilteritinib for Patients With Newly Diagnosed AML With or Without FLT3 Mutations
CTID: NCT04293562
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-22
Combination Chemotherapy, Autologous Stem Cell Transplant, and/or Radiation Therapy in Treating Young Patients With Extraocular Retinoblastoma
CTID: NCT00554788
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-22
Antiangiogenic Therapy for Children with Recurrent Medulloblastoma, Ependymoma and ATRT
CTID: NCT01356290
Phase: Phase 2    Status: Recruiting
Date: 2024-10-21
MOnaliZumab in Combination With durvAlumab (MEDI4736) Plus Platinum-based chemotheRapy for First-line Treatment of Extensive Stage Small Cell Lung Cancer
CTID: NCT05903092
Phase: Phase 2    Status: Recruiting
Date: 2024-10-21
Toripalimab and JS004 Combined With Platinum-based Chemotherapy for Relapsed and Extensive-stage Small Cell Lung Cancer
CTID: NCT06648200
Phase: Phase 2    Status: Not yet recruiting
Date: 2024-10-18
Imatinib Mesylate and Combination Chemotherapy in Treating Patients With Newly Diagnosed Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia
CTID: NCT03007147
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-18
Study of Durvalumab in Combination With Platinum and Etoposide for the First Line Treatment of Patients With Extensive-stage Small Cell Lung Cancer
CTID: NCT04774380
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-18
Dinutuximab, Sargramostim, and Combination Chemotherapy in Treating Patients With Newly Diagnosed High-Risk Neuroblastoma
CTID: NCT03786783
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-10-17
Therapeutic Trial for Patients With Ewing Sarcoma Family of Tumor and Desmoplastic Small Round Cell Tumors
CTID: NCT01946529
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-10-17
A Study of Daratumumab and Dose-Adjusted EPOCH in Plasmablastic Lymphoma
CTID: NCT04139304
PhaseEarly Phase 1    Status: Active, not recruiting
Date: 2024-10-16
Olaparib and Durvalumab With Carboplatin, Etoposide, and/or Radiation Therapy for the Treatment of Extensive-Stage Small Cell Lung Cancer, PRIO Trial
CTID: NCT04728230
Phase: Phase 1/Phase 2    Status: Recruiting
Date: 2024-10-16
Lamivudine in Combination With Chemoimmunotherapy for the Treatment of Extensive Stage Small Cell Lung Cancer
CTID: NCT04696575
Phase: Phase 2    Status: Recruiting
Date: 2024-10-16
Mitotane With or Without Cisplatin and Etoposide After Surgery in Treating Patients With Stage I-III Adrenocortical Cancer With High Risk of Recurrence
CTID: NCT03583710
Phase: Phase 3    Status: Recruiting
Date: 2024-10-15
Ruxolitinib With De-Intensified HLH-94 for the Treatment of Hemophagocytic Lymphohistiocytosis (HLH)
CTID: NCT06160791
Phase: Phase 2    Status: Recruiting
Date: 2024-10-15
Cisplatin and Combination Chemotherapy in Treating Children and Young Adults With Hepatoblastoma or Liver Cancer After Surgery
CTID: NCT03533582
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-15
Comparing Photon Therapy To Proton Therapy To Treat Patients With Lung Cancer
CTID: NCT01993810
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-10
Study of Atezolizumab Plus Carboplatin and Etoposide With or Without Tiragolumab in Participants With Untreated Extensive-Stage Small Cell Lung Cancer
CTID: NCT04665856
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-10
A Study of Atezolizumab Plus Carboplatin and Etoposide With or Without Tiragolumab in Patients With Untreated Extensive-Stage Small Cell Lung Cancer
CTID: NCT04256421
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-10
Adaptive SBRT Plus Chemoimmunotherapy for ES-SCLC
CTID: NCT05403723
Phase: Phase 1    Status: Suspended
Date: 2024-10-10
Study of Treatment for Patients With Cancer of the Eye -Retinoblastoma
CTID: NCT00186888
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-09
2015-12: a Study Exploring the Use of Early and Late Consolidation/Maintenance Therapy
CTID: NCT03004287
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-10-09
Nivolumab, Ifosfamide, Carboplatin, and Etoposide as Second-Line Therapy in Treating Patients With Refractory or Relapsed HL
CTID: NCT03016871
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-10-09
Study of Magrolimab Combinations in Participants With Myeloid Malignancies
CTID: NCT04778410
Phase: Phase 2    Status: Completed
Date: 2024-10-08
Safety and Efficacy of Rituximab for Treatment of Multicentric Castleman Disease in Malawi
CTID: NCT04585893
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-10-03
A Study of Venetoclax in Combination With Conventional Chemotherapy in Pediatric Patients With Acute Myeloid Leukemia
CTID: NCT05955261
Phase: Phase 2    Status: Recruiting
Date: 2024-10-02
Supraphysiological Androgen to Enhance Chemotherapy Treatment Activity in Metastatic Castration-Resistant Prostate Cancer, SPECTRA Study
CTID: NCT06039371
Phase: Phase 2    Status: Recruiting
Date: 2024-10-01
Polatuzumab Vedotin and Combination Chemotherapy With or Without Glofitamab for the Treatment of Untreated Aggressive Large B-cell Lymphoma
CTID: NCT04231877
Phase: Phase 1    Status: Recruiting
Date: 2024-10-01
Combination Chemotherapy Followed By Peripheral Stem Cell Transplant in Treating Young Patients With Newly Diagnosed Supratentorial Primitive Neuroectodermal Tumors or High-Risk Medulloblastoma
CTID: NCT00336024
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-10-01
First Line Chemotherapy for Classical Hodgkin Lymphoma in Russia (HL-Russia-1)
CTID: NCT04638790
Phase: Phase 3    Status: Recruiting
Date: 2024-09-27
Chemotherapy (DA-EPOCH+/-R) and Targeted Therapy (Tafasitamab) for the Treatment of Newly-Diagnosed Philadelphia Chromosome Negative B Acute Lymphoblastic Leukemia
CTID: NCT05453500
Phase: Phase 2    Status: Recruiting
Date: 2024-09-26
Brentuximab Vedotin for Newly Diagnosed cHL in Chinese CAYA Based on PET/CT Assessment
CTID: NCT06563245
Phase: Phase 2/Phase 3    Status: Not yet recruiting
Date: 2024-09-26
A Study of Adebelimab Combined With Chemotherapy as a First-line Treatment Sequential Treatment for Extensive-stage Small Cell Lung Cancer
CTID: NCT06614621
Phase: Phase 2    Status: Not yet recruiting
Date: 2024-09-26
Combination Chemotherapy With or Without Blinatumomab in Treating Patients With Newly Diagnosed BCR-ABL-Negative B Lineage Acute Lymphoblastic Leukemia
CTID: NCT02003222
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-09-24
Novel Combination Therapy in the Treatment of Relapsed and Refractory Aggressive B-Cell Lymphoma
CTID: NCT02436707
Phase: Phase 2    Status: Recruiting
Date: 2024-09-23
Testing the Addition of an Anti-cancer Drug, Lenalidomide, to the Usual Combination Chemotherapy Treatment ('EPOCH') for Adult T-Cell Leukemia-Lymphoma (ATL)
CTID: NCT04301076
Phase: Phase 1    Status: Recruiting
Date: 2024-09-20
MT2022-60: Ph 2 Study of Pembro+ BEAM With ASCT for Relapsed Hodgkin Lymphoma
CTID: NCT06377540
Phase: Phase 2    Status: Not yet recruiting
Date: 2024-09-19
A Study Evaluating the Efficacy, Safety, and Pharmacokinetics of Glofitamab in Combination With Rituximab Plus Ifosfamide, Carboplatin Etoposide Phosphate in Participants With Relapsed/Refractory Transplant or CAR-T Therapy Eligible Diffuse B-Cell Lymphoma
CTID: NCT05364424
Phase: Phase 1    Status: Active, not recruiting
Date: 2024-09-19
Combination Chemotherapy in Treating Patients With Non-Metastatic Extracranial Ewing Sarcoma
CTID: NCT01231906
Phase: Phase 3    Status: Active, not recruiting
Date: 2024-09-19
First-Line Tarlatamab in Combination With Carboplatin, Etoposide, and PD-L1 Inhibitor in Subjects With Extensive Stage Small Cell Lung Cancer (ES-SCLC)
CTID: NCT05361395
Phase: Phase 1    Status: Active, not recruiting
Date: 2024-09-19
Loncastuximab Tesirine in Combination with DA-EPOCH-R in Patients with Previously Untreated Aggressive B-cell Lymphoid Malignancies
CTID: NCT05270057
Phase: Phase 1    Status: Recruiting
Date: 2024-09-19
Thoracic Radiotherapy Plus Maintenance Durvalumab After First Line Carboplatin and Etoposide Plus Durvalumab in Extensive-stage Disease Small Cell Lung Cancer (ED-SCLC).
CTID: NCT04472949
Phase: Phase 2    Status: Active, not recruiting
Date: 2024-09-19
Pembrolizumab with Combination Chemotherapy in Treating Participants with Locally Advanced or Metastatic Small Cell/Neuroendocrine Cancers of Urothelium or Prostate
CTID: NCT03582475
Phase: Phase 1    Status: Active, not recruiting
Date: 2024-09-19
A Study of PM8002 (Anti-PD-L1/VEGF) in Combination lse if(down_display === 'none' || down_display === '') { icon_angle_up.style.display = 'non

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