Trabectedin in the treatment of patients with soft tissue sarcoma

Abstract

Soft tissue sarcomas (STS) are rare malignant tumours derived from connective tissue. They constitute about 1% of malignancies occurring in adults. We distinguish over 60 subtypes of soft tissue sarcoma, each with a unique clinical course and a diversified response to systemic treatment. The prognosis for patients with locally advanced, unresectable or metastatic disease remains poor. For years, doxorubicin-used alone or in combination with ifosfamide-has been the basis of treatment for these patients. Trabectedin is a relatively new molecule registered in the treatment of patients diagnosed with STS. The drug was originally obtained from marine tunicates (Ecteinascidia turbinata), currently it is obtained semi-synthetically. So far, a number of potential mechanisms of trabectedin have been described, including DNA-binding, disruption of DNA repair mechanisms and cell cycle, as well as effects on transcription factors and the tumour microenvironment. The aim of the following review is to summarize the current knowledge on the efficacy and safety of trabectedin in the treatment of patients diagnosed with STS.

Established and Experimental Systemic Treatment Options for Advanced Liposarcoma

“…Demetri et al not reached in patients treated with trabectedin [46,47]. In a study with 52 patients with advanced pretreated MLPS, the ORR was 51% (including two complete remissions), the mPFS was 14 months, and the 6-month PFS rate was 88% in patients treated with trabectedin [47,48].…”

“…Demetri et al not reached in patients treated with trabectedin [46,47]. In a study with 52 patients with advanced pretreated MLPS, the ORR was 51% (including two complete remissions), the mPFS was 14 months, and the 6-month PFS rate was 88% in patients treated with trabectedin [47,48]. As trabectedin is not neuro-or cardiotoxic, and the hepatic toxicity and neutropenia that may occur are not cumulative, trabectedin as a prolonged treatment may be appropriate and should also be evaluated in combination with other treatments [27].…”