Indications
Lurbinectedin is an anticancer medicine used in adults to treat small cell lung cancer that has spread (metastatic) and has come back or progressed during or after platinum based chemotherapy.
How It Works
Lurbinectedin binds to the DNA of cancer cells and blocks the process by which genes are read (transcription). This damages the DNA, stops the cells from dividing and causes them to die. It also affects certain immune cells around the tumour that help cancers grow.
Dosage and Administration
Lurbinectedin is given as prescribed by a cancer specialist, as a drip into a vein (infusion) over about 1 hour by a doctor or nurse in hospital, usually once every 21 days. The dose is based on body surface area and is adjusted or delayed according to blood counts, liver tests and side effects. Medicines to prevent nausea and vomiting are given before each infusion.
Interactions
- Strong or moderate CYP3A blockers such as Ketoconazole, Itraconazole, Clarithromycin, Ritonavir and grapefruit juice raise lurbinectedin levels and should be avoided.
- Strong CYP3A inducers such as Rifampicin, Carbamazepine, Phenytoin and St John’s wort lower its levels and should be avoided.
- Live vaccines should not be given during treatment.
Contraindications
- Allergy to lurbinectedin or any ingredient.
- Severely low neutrophil or platelet counts before a dose.
- Breastfeeding.
Side Effects
Very common: low white cells, red cells and platelets, tiredness, nausea, vomiting, loss of appetite, constipation or diarrhoea, muscle and joint pain, shortness of breath, cough and raised liver enzymes. Serious: fever with low white cells (febrile neutropenia), serious infections including pneumonia, bleeding, liver damage, and severe tissue damage if the drug leaks out of the vein during the infusion. Rarely, severe muscle breakdown (rhabdomyolysis) can occur.
Get urgent medical help for fever of 38°C or more, chills, bleeding or unusual bruising, severe vomiting or diarrhoea, yellowing of the skin or eyes, severe muscle pain or dark urine, breathing difficulty, or pain, swelling or redness at the infusion site.
Pregnancy and Lactation
Lurbinectedin can harm an unborn baby. Women who could become pregnant must use effective contraception during treatment and for some months after the last dose, and men with female partners must also use effective contraception for some months, as advised by the doctor. Do not breastfeed during treatment and for some time afterwards. It may affect fertility.
Precautions and Warnings
Used only under the supervision of specialists in cancer chemotherapy. Blood counts and liver function are checked before each dose. Medicines to raise white cell counts may be given. Avoid people with infections, and report any sign of infection quickly. Use with care in liver impairment. A central venous line may be used to reduce the risk of leakage.
Overdose
Overdose is expected to cause severe bone marrow suppression and other serious side effects. It is managed in hospital with close monitoring and supportive care such as white cell growth factors, transfusions and antibiotics.
Therapeutic Class
Antineoplastic, alkylating agent (DNA binding transcription inhibitor)
Storage
Hospital and specialist medicine: store as directed on the pack, out of the reach of children. Cytotoxic waste must be handled and disposed of safely.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.