methotrexate + etoposide

Methotrexate + etoposide is a combination chemotherapy regimen consisting of two antineoplastic agents with complementary mechanisms of action. Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, blocking DNA synthesis and cell proliferation primarily in the S phase of the cell cycle. It effectively inhibits trophoblast cell proliferation by preventing DNA replication. Etoposide is a topoisomerase II inhibitor that causes DNA double-strand breaks and prevents DNA re-ligation, inducing cell cycle arrest in G2 and S phases and triggering apoptosis through the caspase 9 pathway. The combination has been studied in various cancers including gestational trophoblastic neoplasia (GTN), leukemia L1210, and medulloblastoma. The regimen demonstrates schedule-dependent and sequence-dependent synergism, with optimal therapeutic effect achieved when specific timing intervals are maintained between drug administrations. This combination has shown efficacy in low-risk GTN patients who fail single-agent methotrexate therapy, and has been investigated for intraventricular administration in brain tumors.

Other names

MTX + ETPMTX + etoposidemethotrexate + Vepesid