Clinical data | |
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Trade names | Vumon |
Other names | VM-26 |
AHFS/ Drugs.com | Monograph |
MedlinePlus | a692045 |
Pregnancy category |
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Routes of administration | Intravenous |
ATC code | |
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Pharmacokinetic data | |
Bioavailability | N/A |
Protein binding | >99% |
Metabolism | Hepatic ( CYP2C19-mediated) |
Elimination half-life | 5 hours |
Excretion | Renal and fecal |
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CAS Number | |
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IUPHAR/BPS | |
DrugBank | |
ChemSpider | |
UNII | |
KEGG | |
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CompTox Dashboard ( EPA) | |
ECHA InfoCard | 100.045.286 |
Chemical and physical data | |
Formula | C32H32O13S |
Molar mass | 656.66 g·mol−1 |
3D model ( JSmol) | |
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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]
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, sulfamethizole or tolbutamide, 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]