Introduction
Lastet is used to treat different cancers of lung, and testicles. It is also sometimes used to treat some other kinds of cancer in both men and women. It can be used on its own, or sometimes given together with certain other medicines as part of combination chemotherapy.
Lastet is given as slow injection into veins under the supervision of a healthcare professional and should not be self-administered. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.
The most common side effect of this medicine includes low blood platelets, vomiting, nausea, hair loss, and anemia (low number of red blood cells). If these bother you or appear serious, let your doctor know. There may be ways of reducing or preventing them. It is important to use effective contraception to avoid getting pregnant or fathering a child during treatment.
Before taking this medicine, let your doctor know if you have liver or kidney disease, or if have been on radiation therapy. Your doctor should also know about all other medicines you are taking as many of these may make this medicine less effective or change the way it works. Tell your doctor if you are pregnant or breastfeeding. Your doctor may check you for blood cells and liver functioning while taking this medicine.
Uses of Lastet
- Small cell lung cancer
- Testicular cancer
Side effects of Lastet
Common
- Anemia (low number of red blood cells)
- Decreased blood cells (red cells, white cells, and platelets)
- Decreased white blood cell count
- Diarrhea
- Hair loss
- Liver damage
- Low blood platelets
- Nausea
- Rash
- Stomatitis (Inflammation of the mouth)
- Vomiting
How to use Lastet
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Lastet works
Lastet is an anti-cancer medication. It works by suppressing the activity of an enzyme (topoisomerase II) involved in DNA multiplication of the cancer cells. This slows the growth of cancer cells and eventually kills them.
Indication
Lung cancer, Testicular cancer
Adult Dose
Intravenous
Testicular Cancer
50-100 mg/m²/day IV on days 1-5, OR
100 mg/m²/day IV on days 1, 3, 5
Repeat q3-4week
Small-Cell Lung Cancer
35 mg/m²/day IV for 4 days, OR
50 mg/m²/day IV for 5 days; repeat q3-4week
Oral
Small cell lung cancer
Adult: Twice the IV dose, rounded to the nearest 50 mg.
Renal Dose
Renal Impairment
CrCl >50 mL/min: Dose adjustment not necessary
CrCl 15-50 mL/min: 75% of regular dose
CrCl < 15 mL/min: Not studied; consider further dose reductions
Contraindication
Hypersensitivity, pregnancy, lactation.
Mode of Action
Etoposide is a derivative of podophyllotoxin that inhibits DNA synthesis resulting in the arrest of the cell cycle. At low doses, it inhibits cells from entering cell cycle and at high doses, cells entering mitosis are lysed.
Precaution
Skin reactions may occur with accidental exposure; renal or hepatic disease. Periodic CBCs should be done before, during and after therapy. Increased risk of etoposide-toxicity in patients with low serum albumin. Acrylic material has been shown to crack and leak when used with undiluted etoposide inj.
Lactation: not known if excreted in breast milk, discontinue drug or do not nurse
Side Effect
>10%
Leukopenia (60-91%),Nausea and Vomiting (30-40%),Thrombocytopenia (28-41%),Alopecia (20-90%),Anorexia (13%),Diarrhea (13%),Leukopenia (60-91%),Anemia (≤33%)
1-10%
Pancytopenia (7%),Stomatitis (6%),Hepatic toxicity (3%),Type 1 hypersensitivity (2%),Orthostatic hypotension (1-2%),Peripheral neuropathy (1-2%)
Frequency Not Defined
Malaise,Shivering,Asthenia,Fever,Mucous membrane inflammation,Hyperuricemia,Local soft tissue toxicity has been reported following extravasation; see section on IV information for extravasation management
Potentially Fatal: Severe myelosuppression, characterised by leucopaenia and thrombocytopaenia. Cardiotoxicity. Anaphylaxis.
Pregnancy Category Note
Pregnancy: Based on animal data and its mechanism of action, etoposide can cause fetal harm when administered to a pregnant woman; etoposide, the active moiety of etoposide phosphate is teratogenic in mice and rats advise pregnant women of potential hazard to a fetus; advise women of childbearing potential to avoid becoming pregnant
Advise females of reproductive potential to use effective contraception during treatment and for 6 months after final dose In females of reproductive potential, may cause infertility and result in amenorrhea; premature menopause can occur; recovery of menses and ovulation is related to age at treatment
Lactation: There is no information regarding presence of etoposide in human milk or its effects on breastfed infant milk production; because of potential for serious adverse reactions in nursing infants, advise women not to breastfeed during treatment with etoposide
Interaction
Synergism with other cytotoxic drugs. Caution when admin with drugs that inhibit phosphatase activity. Cyclosporin A may reduce the clearance of etoposide.