Can Pregnancy Occur During Lurbinectedin Treatment?
Yes, pregnancy can occur during lurbinectedin (Zepzelca) treatment, as the drug does not prevent ovulation or contraception failure. It carries a boxed warning for embryo-fetal toxicity: lurbinectedin can cause fetal harm if administered to pregnant women, based on animal studies showing reduced fertility and fetal loss.[1][2]
What Contraception Is Required?
Females of reproductive potential must use effective contraception during treatment and for 6 months after the last dose. Males with female partners of reproductive potential should use contraception during treatment and for 4 months after.[1][2] Verify pregnancy status before starting and avoid pregnancy planning until after these periods.
Risks to Fetus If Pregnant During Treatment
Animal data show developmental toxicity, including post-implantation loss and malformations, at doses below human equivalents. No human pregnancy data exist, but the risk is considered high enough for the warning. Discontinue treatment if pregnancy occurs.[1][2]
Fertility Effects After Treatment
Lurbinectedin may impair male and female fertility. Cryopreservation of sperm or eggs is recommended before starting for those planning future pregnancies.[1][2]
How Does This Compare to Other Chemotherapy Drugs?
Like many chemotherapies (e.g., platinum-based agents), lurbinectedin requires strict contraception due to genotoxicity, but its 6-month post-treatment window for females exceeds some (e.g., 3-6 months for doxorubicin). Always check drug-specific labels.[1]
Sources
[1]: Zepzelca (lurbinectedin) Prescribing Information, Jazz Pharmaceuticals, https://www.zepzelca.com/pdf/zepzelca-prescribing-information.pdf
[2]: FDA Label for Lurbinectedin, https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/213069s000lbl.pdf