Trabectedin for the management of soft-tissue sarcoma.

Trabectedin is a new marine-derived compound that binds the DNA minor groove and interacts with proteins of the DNA-repair machinery. Trabectedin has shown promising single-agent activity in pretreated patients with soft-tissue sarcoma (STS) and ovarian and breast cancer; combination with various other chemotherapeutic drugs is feasible. Toxicities are mainly hematological and hepatic, with grade 3-4 neutropenia and thrombocytopenia observed in approximately 50 and 20% of patients, respectively, and grade 3-4 elevation of liver transaminases observed in 35-50% of patients treated with trabectedin. Trabectedin obtained regulatory approval by the EMEA and in other countries for the treatment of STS patients after failure of all available standard-of-care chemotherapy. Current research focuses on the identification of predictive factors for patients treated with trabectedin as well as the development of other combinations.