Successful rechallenge to etoposide after an acute vasomotor response.

Abstract

To the Editor: Athanassiou et al describe their experience with acute vasomotor responses to etoposide (VP-16) in four of 31 consecutive patients given VP-16 for advanced ovarian cancer. Similar adverse reactions to epipodophyllotoxins have been reported by others and consist of the acute development of hypertension, tachycardia, flushing, substernal chest discomfort, and sweating. The symptoms abate with discontinuation of the VP-16 infusion, and none of these patients were rechallenged. One of our patients recently had a similar reaction to VP-16, and we now report our successful rechallenge and continued use of VP-16 with a change of rate of delivery and with premedication. A 57-year-old man with metastatic germ cell carcinoma was placed on a standard regimen of cisplatin, VP-16, and bleomycin. His first cycle was tolerated without any adverse reaction. Three weeks later, he was admitted for a second cycle of chemotherapy. His VP-16 was mixed at a concentration of 200 mg in 250 cc normal saline solutio...