Lurbinectedin
Alkylating agents
Alkylating agentsHigh alert
An error with this medicine can cause serious harm: double checks and protocols are used.Pregnancy: avoid
Avoid in pregnancy. Lurbinectedin may harm the fetus: women and men with partners who could conceive use contraception during and for months after treatment, and breastfeeding is…
An IV drug that binds the DNA minor groove and stops cancer cells dividing; used in small cell lung cancer. Watch blood counts, liver and the vein.
Quick facts
- Group
- Alkylating agents
- Target
- DNA minor groove (guanines)
- Used for
- Metastatic small cell lung cancer
- Key effects
- Fatigue · Nausea · Joint or bone pain
- Monitor
- Complete blood count before each dose · Liver tests
- ATC
- L01XX69
No doses: the clinician sets them by the current guideline.
Mechanism of action
The crystal shows lurbinectedin bound in the minor groove of a short DNA double helix.
Lurbinectedin, a relative of trabectedin, binds covalently to guanines in the minor groove of DNA and widens the groove. The adducts delay progress through S phase, arrest the cell cycle in G2/M and kill the tumour cell.
- Binds covalently to guanines in the DNA minor groove
- The adducts distort DNA and slow S phase
- Cells arrest in G2/M and die
Indications
- Metastatic small cell lung cancer that progressed during or after platinum chemotherapy; also, with atezolizumab, as maintenance in extensive-stage disease after first induction. Lung cancer →
Adverse effects
Common
- Fatigue
- Nausea, vomiting, diarrhoea, constipation, loss of appetite
- Joint or bone pain, headache
- Tingling or numbness of hands and feet
Contraindications
- Hypersensitivity to lurbinectedin
Key interactions
- Grapefruit, Seville oranges and their juices
- Can raise lurbinectedin levels; they are avoided.
- St John's wort
- Can change lurbinectedin levels; it is avoided.
What is monitored
- Complete blood count before each dose
- Liver tests
- Infusion site
- Muscle pain or weakness
Administration and safety
- Hazardous cytotoxic, given only into a vein; a central line is often used.
- The site is watched for pain, swelling or redness, signs of extravasation.
- Antiemetics are given before infusion.
Pregnancy and breastfeeding
Avoid in pregnancy. Lurbinectedin may harm the fetus: women and men with partners who could conceive use contraception during and for months after treatment, and breastfeeding is stopped.
Nursing care
- Check blood counts and liver tests before each cycle.
- Teach to report fever, chills, bleeding, jaundice or dark urine.
- Watch the infusion site and stop if leakage is suspected.
- Teach to avoid grapefruit, Seville oranges and St John's wort.
Pharmacokinetics
- Absorption
- Given into a vein over about an hour, every few weeks.
Test yourself
Think of the answer, then tap the question to see it.
Where on DNA does lurbinectedin bind?
In the minor groove, at guanine bases.
Which cancer is lurbinectedin used for?
Small cell lung cancer.
Which fruits are avoided with lurbinectedin?
Grapefruit and Seville oranges, and their juices.
Connections
← Back to the class: Alkylating agents
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Lurbinectedin Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Lurbinectedin - NCI (National Cancer Institute, 2026); RCSB PDB - 9T8E: Crystal structure of lurbinectedin bound to 10-mer duplex DNA (RCSB Protein Data Bank, 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.