VP-16-213 (Etoposide): The Mandrake Root from Issyk-Kul

The document from 1982 discusses the antineoplastic agent VP-16-213 (etoposide), derived from the May apple plant, and its effectiveness in treating various cancers. Etoposide showed promising results, particularly in small cell lung cancer, with response rates of 37% as a single agent and up to 95% in combination therapies. In non-Hodgkin's lymphoma, 19% of pretreated patients responded, while 24% of pretreated Hodgkin's disease patients responded. A notable 78% response rate was observed in untreated patients with diffuse large cell lymphocytic lymphoma. In acute non-lymphocytic leukemia, 20.5% of patients had partial or complete remissions. The drug also had a 34% response rate in germ cell neoplasms and is used in second-line therapy for refractory cases. However, its effectiveness was limited in non-small cell lung cancer and breast cancer. The toxicity profile was considered acceptable, with hematologic toxicity being the most significant and less than 50% of patients experiencing side effects like alopecia, stomatitis, nausea, and vomiting. The document concludes that VP-16-213 is clinically useful for certain cancers and warrants further study for others.