Oral etoposide

Etoposide, a semisynthetic derivative of podophyllotoxin, has been commercially available for intravenous use for a number of years, and has been used as part of first-line combination chemotherapy programs for small cell lung cancer (SCLC). It has also been used to treat testicular cancer, non-small cell lung cancer, and a variety of other malignancies. Etoposide for oral use has become commercially available and is approved for use in the treatment of SCLC. Although no clinical trials comparing intravenous and oral etoposide in SCLC have been reported, several pharmacokinetic studies have been described. These studies have demonstrated a mean bioavailability of 50 percent, with a wide range among patients. Other pharmacokinetic parameters are similar for both the intravenous and oral methods of administration. Based on these results, the recommended dose of oral etoposide is twice the intravenous dose. Oral etoposide has been demonstrated to be effective in the treatment of SCLC. It offers a reasonable and cost-effective outpatient alternative for this group of patients.