用於含鉑劑化療(platinum-based chemotherapy)後轉移性小細胞肺癌（SCLC）的成年患者。

Antineoplastic Agent, Alkylating Agent

Distribution: 504 L.
Protein binding: ~99% to both albumin and α-1-acid glycoprotein.
Metabolism: Primarily hepatic, via CYP3A.
Half-life elimination: 51 hours.
Excretion: Feces: 89%; urine: 6%.
Clearance: 11 L/hour.

Hypersensitivity to lurbinectedin or any component of the formulation.

In utero exposure to lurbinectedin may cause fetal harm.

Advise not to breastfeed.

laboratory abnormalities (≥20%), leukopenia (79%), lymphopenia (79%), fatigue (77%), anemia (74%), neutropenia (71%), increased creatinine (69%), increased alanine aminotransferase (66%), increased glucose (52%), thrombocytopenia (37%), nausea (37%), decreased appetite (33%), musculoskeletal pain (33%), decreased albumin (32%), constipation (31%), dyspnea (31%), decreased sodium (31%), increased aspartate aminotransferase (26%), vomiting (22%), decreased magnesium (22%), cough (20%), and diarrhea (20%).

Administer Zepzelca as an intravenous infusion over 60 minutes.
Small cell lung cancer, metastatic: 3.2 mg/m2 once every 21 days until disease progression or unacceptable toxicity.

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Adjustment for Toxicity:

Dose reduction level	Dose
Initial (usual) dose	3.2 mg/m2 once every 21 days
First dose reduction	2.6 mg/m2 once every 21 days
Second dose reduction	2 mg/m2 once every 21 days
If unable to tolerate 2 mg/m2 dose, or require >2 week dose delay	Permanently discontinue lurbinectedin

Hepatic impairment prior to treatment initiation:
Mild impairment (total bilirubin ≤ ULN and AST > ULN or total bilirubin 1 to 1.5 times ULN and any AST): no dosage adjustment is necessary.
Hepatotoxicity during treatment:
Grade 2: withhold lurbinectedin until improved to ≤ grade 1, then resume lurbinectedin at the same dose.
Grade 3 or higher: withhold lurbinectedin until improved to ≤ grade 1, then resume lurbinectedin at a reduced dose or permanently discontinue lurbinectedin.