Oral etoposide in lymphoma

Etoposide is one of the most active agents for the therapy of lymphomas. Oral etoposide has proven to be active in and clearly beneficial for patients with previously treated lymphomas. The optimal dose and schedule of oral etoposide for use in combination chemotherapy are still uncertain, but low daily doses (50 to 100 mg) for 10 to 14 days may be near optimal. Studies in previously untreated patients using combination chemotherapy that includes oral etoposide are needed, since preliminary data suggest that this agent has excellent activity and tolerability when combined or alternated with methotrexate, calcium folinate (calcium leucovorin), cyclophosphamide, vincristine, and prednisone in the elderly and medically unfit patient. Combination therapy approaches may also be helpful in HIV-related lymphomas. Additional studies are warranted.