Hypersensitivity Induced by Intravenous

Etoposide (VP-16) exerts its anticancer effects by inhibiting the enzyme, topoisomerase II. This ultimately leads to unrepaired breaks in cellular DNA. The U.S. Food and Drug Administration (FDA) approved etoposide for treatment of small cell lung cancer and refractory testicular cancer. It also has been used to treat acute lymphoid leukemia, acute myeloid leukemia, Hodgkin’s and non-Hodgkin’s lymphoma. Common side effects include bone marrow suppression, alopecia, and gastrointestinal symptoms. Hypersensitive reactions to etoposide are uncommon and the underlying mechanism is unclear. A 71-year-old man with adenocarcinoma lung cancer experienced acute dyspnea, chest tightness, mild hypertension and hypoxia minutes after starting an infusion of etoposide. The infusion was stopped immediately, pharmacologic agents were administered and the symptoms of hypersensitivity were resolved. Subsequently, the patient was given paclitaxel without incident. Chiang Mai Medical Journal 2011;50(3):89-93