title: Trabectedin for the treatment of breast cancer.
abstract: BACKGROUND
  Trabectedin is an anti-tumor compound registered in Europe and in several other countries, for the second-line treatment of soft tissue sarcoma (STS) and for ovarian cancer in combination with liposomal doxorubicin. Trabectedin inhibits cancer cell proliferation mainly affecting the transcription regulation. Trabectedin also acts as a modulator of tumor microenvironment by reducing the number of tumor associated macrophages (TAM). Because of its unique mechanism of action, trabectedin has the potential to act as antineoplastic agent also in several solid malignancies, including breast cancer (BC).
  
  
  METHODS
  This article reviews the preclinical and clinical data of trabectedin focusing on development in metastatic BC (mBC). Comments regarding the nature and the results of these trials are included.
  
  
  CONCLUSIONS
  Trabectedin is thought to have a crucial activity with defective DNA-repair machinery and also in modulating the tumor micro-environment and the immune-system of cancer patients. From the current available data, we recognize a potential activity of trabectedin in mBC and support the renewed efforts to better elucidate the value of trabectedin in this indication.
authors.affiliation: a Department of Oncology , IRCCS - Istituto di Ricerche Farmacologiche Mario Negri , Via La Masa 19, Milan 20156 , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: D'Incalci
authors.affiliation: b Medical Oncology , Papa Giovanni XXIII Hospital , P.zza OMS 1, Bergamo 24127 , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zambelli
mesh_terms: D000818:Animals; D018906:Antineoplastic Agents, Alkylating / Q000494:pharmacology / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004260:DNA Repair / Q000187:drug effects; D004149:Dioxoles / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D044005:Tetrahydroisoquinolines / Q000494:pharmacology / Q000627:therapeutic use*; D000077606:Trabectedin; D059016:Tumor Microenvironment / Q000187:drug effects
chemical_list: D018906:Antineoplastic Agents, Alkylating; D004149:Dioxoles; D044005:Tetrahydroisoquinolines; D000077606:Trabectedin
keywords: BRCA mutation; DNA repair; metastatic breast cancer; trabectedin