Lurbinectedin

Lurbinectedin Brand Name– ZEPZELCA

What is Lurbinectedin

Lurbinectedin is an intravenous alkylating agent. It is indicated for the treatment of metastatic small cell lung cancer (SCLC) with disease progression on or after platinum-based chemotherapy.

Treatment with lurbinectedin is associated with potentially severe myelosuppression; it is more common in patients 65 years of age or older.

Monitor blood counts prior to each dose of lurbinectedin and do not initiate or continue treatment until the neutrophil count is at least 1,500 cells/mm3 and the platelet count is at least 100,000 cells/mm3.

Indications

  • small cell lung cancer (SCLC)

For the treatment of small cell lung cancer (SCLC)

for the treatment of metastatic SCLC with disease progression on or after platinum-based chemotherapy, as monotherapy

Side Effects

  1. abdominal pain
  2. abdominal pain
  3. anemia
  4. anorexia
  5. anorexia
  6. arthralgia
  7. back pain
  8. bone marrow suppression
  9. bone pain
  10. chest pain (unspecified)
  11. constipation
  12. cough
  13. diarrhea
  14. diarrhea
  15. dysgeusia
  16. dyspnea
  17. dyspnea
  18. elevated hepatic enzymes
  19. fatigue
  20. fatigue
  21. fever
  22. headache
  23. headache
  24. hepatotoxicity
  25. hyperesthesia
  26. hyperglycemia
  27. hypoalbuminemia
  28. hypoesthesia
  29. hypomagnesemia
  30. hyponatremia
  31. infection
  32. infection
  33. leukopenia
  34. lymphopenia
  35. musculoskeletal pain
  36. musculoskeletal pain
  37. myalgia
  38. nausea
  39. neutropenia
  40. paresthesias
  41. peripheral neuropathy
  42. peripheral neuropathy
  43. pneumonitis
  44. thrombocytopenia
  45. vomiting

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing

Contraindications

  • bone marrow suppression
  • breast-feeding
  • contraception requirements
  • geriatric
  • hepatic disease
  • hepatotoxicity
  • male-mediated teratogenicity
  • neutropenia
  • pregnancy
  • pregnancy testing
  • reproductive risk
  • thrombocytopenia

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Amiodarone
  • Amobarbital
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Apalutamide
  • Aprepitant, Fosaprepitant
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Bexarotene
  • Bosentan
  • Brigatinib
  • Butabarbital
  • Carbamazepine
  • Cenobamate
  • Ceritinib
  • Chloramphenicol
  • Ciprofloxacin
  • Clarithromycin
  • Cobicistat
  • Conivaptan
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Danazol
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Dexamethasone
  • Diltiazem
  • Dronedarone
  • Duvelisib
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enzalutamide
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Eslicarbazepine
  • Etravirine
  • Fedratinib
  • Fluconazole
  • Fluvoxamine
  • Fosamprenavir
  • Fosphenytoin
  • grapefruit juice
  • Idelalisib
  • Imatinib
  • Indinavir
  • Isavuconazonium
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ketoconazole
  • Letermovir
  • Lopinavir; Ritonavir
  • Lorlatinib
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Mephobarbital
  • Methohexital
  • Mifepristone
  • Mitotane
  • Nafcillin
  • Nefazodone
  • Nelfinavir
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Nilotinib
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Pentobarbital
  • Phenobarbital
  • Phenytoin
  • Posaconazole
  • Primidone
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Saquinavir
  • Secobarbital
  • St. John’s Wort, Hypericum perforatum
  • Telithromycin
  • Thiopental
  • Tipranavir
  • Trandolapril; Verapamil
  • Tucatinib
  • Verapamil
  • Voriconazole
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