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A marine-derived chemotherapy that jams cancer's gene-reading machinery, approved for relapsed small-cell lung cancer and, since 2025, as first-line maintenance with atezolizumab.
Accelerated approval June 2020 for metastatic SCLC after platinum (ORR 35%, DOR 5.3 months, basket phase 2). ATLANTIS (with doxorubicin) missed OS; IMforte (with atezolizumab as first-line maintenance) improved OS and PFS, leading to full approval on 2 October 2025. Also studied in the LAGOON second-line trial. Jazz Pharmaceuticals (US) and PharmaMar.
Ball-and-stick model from PubChem 2D record (no 3D conformer available). PubChem record
Binds the DNA minor groove at CG-rich promoters, stalls RNA polymerase II and triggers its degradation; also depletes tumour-associated macrophages.
1.Binds guanine in the DNA minor groove at active promoters
Source: www.accessdata.fda.gov/drugsatfda_docs/label/2025/213702s004lbl.pdf. Doses are for orientation; the current label governs.
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies.
Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments.
20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
Sources: NICE search: lurbinectedin. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
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Treatment of adult patients with metastatic small cell lung cancer (SCLC) with disease progression on or after prior platinum-based chemotherapy .
Accelerated approval, second-line SCLC The confirmatory requirement was still open 6.3 years later, when the FDA's table was read.
Full approval with atezolizumab as first-line maintenance (IMforte) source
| Region | Year | Indication |
|---|---|---|
| US | 2020 | Metastatic SCLC after platinum chemotherapy (accelerated) |
| US | 2025 | First-line maintenance with atezolizumab in ES-SCLC (full approval) |
| EU | 2026 | Maintenance with atezolizumab in ES-SCLC after first-line induction; 29 May 2026 |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia | 71% | 46% |
| Fatigue | 77% | - |
| Nausea | 37% | - |
| Transaminase increase | 66% | - |
Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
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Query for this drug: (TITLE:"Lurbinectedin" OR ABSTRACT:"Lurbinectedin" OR TITLE:"Zepzelca" OR ABSTRACT:"Zepzelca" OR TITLE:"PM01183" OR ABSTRACT:"PM01183") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Lurbinectedin, not a curated reading list.
Shares Lurbinectedin or in Combination with Irinotecan Versus Topotecan in Patients with Relapsed SCLC, IDeate-Lung02, Study of Sacituzumab Govitecan Versus Standard of Care in Participants With Previously Treated Extensive Stage Small Cell Lung Cancer, Lurbinectedin basket trial, small-cell lung cancer cohort.
Shares Chemo-immunotherapy induction → maintenance intensification (SCLC), Neuroendocrine and small-cell prostate cancer, Limited-stage small-cell lung cancer, Extensive-stage small-cell lung cancer.
Shares Chemo-immunotherapy induction → maintenance intensification (SCLC), Small-cell lung cancer transcription-factor subtypes (SCLC-A, SCLC-N, SCLC-P, SCLC-I) and SLFN11, Lung cancer drugs in England: what NICE has recommended, Small cell lung cancer (KEGG map).
Shares IDeate-Lung02, Study of Sacituzumab Govitecan Versus Standard of Care in Participants With Previously Treated Extensive Stage Small Cell Lung Cancer, Small-cell lung cancer, Cytotoxic chemotherapy.
Shares IDeate-Lung02, Small-cell lung cancer transcription-factor subtypes (SCLC-A, SCLC-N, SCLC-P, SCLC-I) and SLFN11, Small cell lung cancer (KEGG map), Neuroendocrine and small-cell prostate cancer.
Shares Small-cell lung cancer transcription-factor subtypes (SCLC-A, SCLC-N, SCLC-P, SCLC-I) and SLFN11, Neuroendocrine and small-cell prostate cancer, Extensive-stage small-cell lung cancer, Small-cell lung cancer.
Shares Chemo-immunotherapy induction → maintenance intensification (SCLC), Extensive-stage small-cell lung cancer, Small-cell lung cancer, Lung cancer (all types).
Shares Lurbinectedin basket trial, small-cell lung cancer cohort, Extensive-stage small-cell lung cancer, Small-cell lung cancer, Lung cancer (all types).