Teniposide (trade name Vumon) is a chemotherapeutic medication[1] used in the treatment of childhood acute lymphocytic leukemia (ALL), Hodgkin's lymphoma, certain brain tumours, and other types of cancer.[2] It is in a class of drugs known as podophyllotoxin derivatives and slows the growth of cancer cells in the body.[3]
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| Trade names | Vumon |
| Other names | VM-26 |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a692045 |
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| Routes of administration | Intravenous |
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| Bioavailability | N/A |
| Protein binding | >99% |
| Metabolism | Hepatic (CYP2C19-mediated) |
| Elimination half-life | 5 hours |
| Excretion | Renal and fecal |
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| ECHA InfoCard | 100.045.286  |
| Chemical and physical data | |
| Formula | C32H32O13S |
| Molar mass | 656.66 g·mol−1 |
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Teniposide is used for the treatment of a number of cancer types in children. In the US, it is approved for the second-line therapy of acute lymphocytic leukemia (ALL) in combination with other antineoplastic drugs.[3] In Europe, it is also approved for the treatment of Hodgkin's lymphoma, generalized malignant lymphoma, reticulocyte sarcoma, acute leukaemia, primary brain tumours (glioblastoma, ependymoma, astrocytoma), bladder cancer, neuroblastoma and other solid tumours in children.[2]
The medication is injected though a vein and burns if it leaks under the skin. It can be used in combination with other anticancer drugs.[2]
The drug is contraindicated during pregnancy and lactation, in patients with severe liver or kidney impairment or severely impaired haematopoiesis.[2]
Teniposide, when used with other chemotherapeutic agents for the treatment of ALL, results in severe bone marrow suppression. Other common side effects include gastrointestinal toxicity, hypersensitivity reactions, and reversible alopecia.[2]
No systematic interaction studies are available. The enzyme inducers phenobarbital and phenytoin have been found to lower its blood plasma concentrations.[4] Theoretically possible interactions include increased plasma concentrations when combined with sodium salicylate, sulfamethizoleortolbutamide, which displace teniposide from plasma protein binding, at least in vitro.[2][3]
Teniposide causes dose-dependent single- and double-stranded breaks in DNA and DNA-protein cross-links.[2] The substance has been found to act as an inhibitor of topoisomerase II (an enzyme that aids in DNA unwinding),[4][5] since it does not intercalate into DNA or bind strongly to DNA. The cytotoxic effects of teniposide are related to the relative number of double-stranded DNA breaks produced in cells, which are a reflection of the stabilization of a topoisomerase II-DNA intermediate.[citation needed]
Teniposide is a semisynthetic derivative of podophyllotoxin[2] from the rhizome of the wild mandrake (Podophyllum peltatum). More specifically, it is a glycoside of podophyllotoxin with a D-glucose derivative. It is chemically similar to the anti-cancer drug etoposide, being distinguished only by a thienyl rest where etoposide has a methyl.[4] Both these compounds have been developed with the aim of creating less toxic derivatives of podophyllotoxin.[6]