PURPOSE OF REVIEW: The therapeutic armamentarium of adult soft-tissue sarcomas (STS) has widened in recent years. This was also due to increased consideration of their variegated histology. Trabectedin is a new chemotherapeutic agent, which significantly strengthens the armamentarium along this direction. RECENT FINDINGS: Trabectedin has proven efficacy in STS, mainly in leiomyosarcomas, liposarcomas, and other translocation-related sarcomas. Among further subgroups, its activity in uterine leiomyosarcomas is noteworthy. Moreover, it exerts special antitumor activity in myxoid liposarcomas, with distinct patterns of tumor response. Also, its mechanism of action is distinct in myxoid liposarcoma, apparently overcoming lipogenic cell differentiation block due to the tumor chromosomal translocation. Apart from histology, DNA repair mechanisms have been investigated as a predictive factor, with retrospective evidence in support. Combination of trabectedin with doxorubicin has limitations due to additive toxicity. Trabectedin is well tolerated as a single agent. Occasional major myelosuppression is possible but proper patient selection (with a focus on liver tests) and possibly steroid premedication are of help. SUMMARY: Trabectedin is a new marine-derived drug with a definite role in the 'histology-driven' medical therapy of STS. There is room for further investigation, to fully elucidate its efficacy in all STS and optimize tolerability.
PURPOSE OF REVIEW: The therapeutic armamentarium of adult soft-tissue sarcomas (STS) has widened in recent years. This was also due to increased consideration of their variegated histology. Trabectedin is a new chemotherapeutic agent, which significantly strengthens the armamentarium along this direction. RECENT FINDINGS: Trabectedin has proven efficacy in STS, mainly in leiomyosarcomas, liposarcomas, and other translocation-related sarcomas. Among further subgroups, its activity in uterine leiomyosarcomas is noteworthy. Moreover, it exerts special antitumor activity in myxoid liposarcomas, with distinct patterns of tumor response. Also, its mechanism of action is distinct in myxoid liposarcoma, apparently overcoming lipogenic cell differentiation block due to the tumor chromosomal translocation. Apart from histology, DNA repair mechanisms have been investigated as a predictive factor, with retrospective evidence in support. Combination of trabectedin with doxorubicin has limitations due to additive toxicity. Trabectedin is well tolerated as a single agent. Occasional major myelosuppression is possible but proper patient selection (with a focus on liver tests) and possibly steroid premedication are of help. SUMMARY: Trabectedin is a new marine-derived drug with a definite role in the 'histology-driven' medical therapy of STS. There is room for further investigation, to fully elucidate its efficacy in all STS and optimize tolerability.
Authors: Lia Gore; E Rivera; M Basche; S L Moulder-Thompson; J Li; S Eppers; S Grolnic; C O'Bryant; D Cleere; Y A Elsayed; S G Eckhardt Journal: Invest New Drugs Date: 2011-09-20 Impact factor: 3.850
Authors: Patrick J Grohar; Girma M Woldemichael; Laurie B Griffin; Arnulfo Mendoza; Qing-Rong Chen; Choh Yeung; Duane G Currier; Sean Davis; Chand Khanna; Javed Khan; James B McMahon; Lee J Helman Journal: J Natl Cancer Inst Date: 2011-06-08 Impact factor: 13.506
Authors: Yanxia Liu; Lilibeth A Salvador; Seongrim Byeon; Yongcheng Ying; Jason C Kwan; Brian K Law; Jiyong Hong; Hendrik Luesch Journal: J Pharmacol Exp Ther Date: 2010-08-25 Impact factor: 4.030
Authors: Wei-Lien Wang; Daniela Katz; Dejka M Araujo; Vinod Ravi; Joseph A Ludwig; Jonathan C Trent; Shreyaskumar R Patel; Patrick P Lin; Ashleigh Guadagnolo; Dolores Lòpez-Terrada; Angelo Paola Dei Tos; Valerie O Lewis; Dina Lev; Raphael E Pollock; Gunar K Zagars; Robert S Benjamin; John E Madewell; Alexander J Lazar Journal: Clin Sarcoma Res Date: 2012-12-29
Authors: Markus K Schuler; Stephan Richter; Ivan Platzek; Bettina Beuthien-Baumann; Kathrin Wieczorek; Christine Hamann; Johannes Mohm; Gerhard Ehninger Journal: Case Rep Oncol Med Date: 2013-01-16