Drug Detail:Lurbinectedin (Lurbinectedin [ loor-bin-ek-te-din ])
Drug Class: Alkylating agents
Usual Adult Dose for Small Cell Lung Cancer
3.2 mg/m2 IV over 60 minutes every 21 days until disease progression or unacceptable toxicity
Comments:
- Initiate this drug only if absolute neutrophil count (ANC) is at least 1500 cells/mm3 and platelet count is at least 100,000/mm3.
- Consider administering pre-infusion medications for antiemetic prophylaxis: Corticosteroids (e.g., dexamethasone 8 mg IV or equivalent) and serotonin antagonists (e.g., ondansetron 8 mg IV or equivalent).
Use: For the treatment of adult patients with metastatic small cell lung cancer (SCLC) with disease progression on or after platinum-based chemotherapy
Renal Dose Adjustments
Mild to moderate renal impairment: No adjustment recommended.
Severe renal impairment: Data not available
Liver Dose Adjustments
Mild hepatic impairment (total bilirubin ULN or less and AST greater than ULN, or total bilirubin 1 to 1.5 x ULN and any AST): No adjustment recommended.
Moderate to severe hepatic impairment (total bilirubin greater than 1.5 x ULN and any AST): Data not available
Dose Adjustments
DOSE REDUCTION:
- First dose reduction: 2.6 mg/m2 IV over 60 minutes every 21 days
- Second dose reduction: 2 mg/m2 IV over 60 minutes every 21 days
DOSE MODIFICATION FOR ADVERSE REACTIONS:
NEUTROPENIA (patients with isolated Grade 4 neutropenia [neutrophil count less than 500 cells/mm3] may receive G-CSF prophylaxis rather than undergo dose reduction):
- Grade 4 or any Grade febrile neutropenia: Withhold therapy until resolved to Grade 1 or less; resume therapy at a reduced dose.
- Grade 3 with bleeding or Grade 4: Withhold therapy until platelet count is 100,000/mm3 or greater; resume therapy at a reduced dose.
- Grade 2: Withhold therapy until Grade 1 or less; resume therapy at same dose.
- Grade 3 or greater: Withhold therapy until Grade 1 or greater; resume at reduced dose.
Precautions
CONTRAINDICATIONS:
- None
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Advise patients to avoid grapefruit products during therapy with this drug.
Storage requirements:
- Store this drug refrigerated at 2C to 8C (36F to 46F).
- This drug is a hazardous drug. Follow applicable special handling and disposal procedures.
Monitoring:
- Hepatotoxicity
Patient advice:
- Read the approved patient labeling (Patient Information) before you receive this drug the first time and each subsequent dose.
- Do not become pregnant or breastfeed a child while taking this drug.
- Inform your healthcare providers of all concomitant medications, herbal. and
