Respiratory and thoracic cancers:
Indications for ZEPZELCA:
Metastatic small cell lung cancer (SCLC) in adults with disease progression on or after platinum-based chemotherapy.
Consider premedication with corticosteroids, serontonin antagonists. Initiate only if ANC is ≥1500cells/mm3 and platelet count is ≥100000/mm3. Give by IV infusion over 60mins. 3.2mg/m2 every 21 days until disease progression or unacceptable toxicity. Dose modifications for adverse reactions: see full labeling.
Risk of myelosuppression, hepatotoxicity. Monitor blood counts with neutrophils, platelets prior to initiation. If neutrophils <500cells/mm3 or any value less than LLN: give G-CSF. Monitor LFTs prior to, during and as clinically indicated. Moderate or severe hepatic impairment. Elderly. Embryo-fetal toxicity. Advise to use effective contraception during and for 6 months (females of reproductive potential) or 4 months (males w. female partners) after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 2 weeks after the last dose).
Potentiated by strong or moderate CYP3A inhibitors; avoid concomitant use. If concomitant moderate CYP3A inhibitors unavoidable; consider Zepzelca dose reduction. Antagonized by strong CYP3A inducers; avoid concomitant strong or moderate CYP3A inducers.
Leukopenia, lymphopenia, fatigue, anemia, neutropenia, increased creatinine, increased alanine aminotransferase, increased glucose, thrombocytopenia, nausea, decreased appetite, musculoskeletal pain, decreased albumin, constipation, dyspnea, decreased sodium, increased aspartate aminotransferase, vomiting, cough, decreased magnesium, diarrhea.
Generic Drug Availability: