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A growing body of evidences indicates the rise in pharmaceutical contamination of aquatic ecosystems.1-3 Anti-cancer drugs (AKs) are very special because they may avoid some toxicological studies, clinical trials or environmental toxicity assessments imposed for other pharmaceuticals (EMEA, FDA).4-6 In parallel, these drugs require high dosage. It generates high amounts of biologically active molecules into hospital effluents and by extension into surface waters. Both parent-compounds and metabolites are being encountered at high concentrations (ng/L to mg/L).7,8 The original molecules may be generated from the fraction non-metabolized by humans (≅0.40 for etoposide).8 Eventually, it may be the result of accidental spillages or lack of environmental good practices. Among AKs, Etoposide is widely used in chemotherapy (total amount consumed in France in 2004 was 332.84 kg).7 It is prescribed worldwide against lung, testicles and blood cells (lymphoma) cancers in humans.9,10 This plant-derived alkaloid is an anti-neoplasmic, cytotoxic molecule reported to cause single DNA breaks with topoisomerase II inhibiting effects. It has been detected at concentrations up to 5 mg/L in cancer-specialized hospital effluents.8 The pond snail Lymnaea stagnalis inhabits lentic freshwater systems and is ecologically relevant in Holarctic regions of the planet (i.e. northern hemisphere). This gastropod is currently recommended by OECD for full-lifecycle toxicity testing.11 Hemocytes are the circulating immunocompetent cells of Lymnaea stagnalis’ open immune system. Their lymphatic concentration is directly linked to the immune capacity. Immune response substantially depends on phagocytosis. Immunosuppressive effects can increase its vulnerability to multiple biological stressors (such as pathogen invasions) and impair its population.12 We aimed at assessing the acute effects of Etoposide on L. stagnalis’ immune parameters, both at environmentally realistic concentrations and at therapeutic-like concentrations.10

Short-term immunotoxic effects of an anti-cancer drug (Etoposide) on the freshwater pondsnail Lymnaea stagnalis