[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Alkylating agents](https://durgical.com/en/pharmacology/classes/alkylating-agents/) › Lurbinectedin # Lurbinectedin ## Alkylating agents? Alkylating agents ## High 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. Updated Nov 12, 2026 ## Quick facts **Group** [Alkylating agents](https://durgical.com/en/pharmacology/classes/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. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ◆**DNA minor groove (guanines)**Lurbinectedin ⓘ The crystal shows lurbinectedin bound in the minor groove of a short DNA double helix. **Target in 3D:** DNA minor groove (guanines). PDB structure 9T8E (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/9T8E) · Drag to rotate · pinch to zoom 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 →](https://durgical.com/en/conditions/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 ### Serious (rare, important) - Myelosuppression: neutropenia with infection, anaemia, bleeding - Liver injury (jaundice, dark urine) - Tissue damage if the infusion leaks out of the vein - Severe muscle pain or weakness (rhabdomyolysis) ## 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. ## Memory aid «Lurbi in the groove»: it lies in the DNA minor groove and stops the cell from finishing its copy. ## 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. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/lurbinectedin/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **High 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… ## Connections ## Related drugs 1 - [Cyclophosphamide](https://durgical.com/en/pharmacology/cyclophosphamide/) ## Related conditions 1 - [Lung cancer](https://durgical.com/en/conditions/lung-cancer/) [← Back to the class: Alkylating agents](https://durgical.com/en/pharmacology/classes/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](https://medlineplus.gov/druginfo/meds/a620049.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Lurbinectedin - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/lurbinectedin) (National Cancer Institute, 2026); [RCSB PDB - 9T8E: Crystal structure of lurbinectedin bound to 10-mer duplex DNA](https://www.rcsb.org/structure/9T8E) (RCSB Protein Data Bank, 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01XX69) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/lurbinectedin/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/lurbinectedin/