Efficacy of trabectedin for the treatment of liposarcoma.
BACKGROUND
Trabectedin (ET-743) is a synthetic marine derived alkylating agent, extracted originally from a Caribbean Sea sponge. It is approved for the treatment of Soft Tissue sarcomas (STS) in Europe and recently by the FDA for liposarcomas and leiomyosarcomas.


METHODS
Trabectedin has multiple mechanisms of action, including one targeting the FUS-CHOP oncogene in Myxoid/Round cell Liposarcomas. Numerous Phase I, II and III clinical trials have been conducted with Trabectedin. It has been studied as monotherapy or in combination with other chemotherapeutic agents. The recommended dose based on clinical trials is 1.5 milligrams/m(2) continuous infusion over 24 hours once every 3 weeks for STS with evidence of disease control in multiple clinical trials at this dose. The most common Grade 3/4 toxicities include neutropenia and transient noncumulative elevations of ALT and AST. Steroid pretreatment has shown efficacy in reducing liver and bone marrow toxicity. In phase III testing comparing trabectedin to dacarbazine, trabectedin was associated with a significantly improved progression free survival rate in patients with advanced lipo- and leiomyosarcomas.


CONCLUSIONS
Trabectedin is an important new addition to the limited treatment options currently available for STS, especially for patients with liposarcoma that have progressed on standard chemotherapeutic regimens.
a PGY-2 Resident, Department of Internal Medicine , Seton Hall University, Saint Francis Medical Center , Trenton , NJ , USA.
Ritika
R
Zijoo
b Department of Hematology and Medical Oncology , Fox Chase Cancer Center , Philadelphia , PA , USA.
Margaret
M
von Mehren
D018906:Antineoplastic Agents, Alkylating / Q000494:pharmacology / Q000627:therapeutic use*; D004149:Dioxoles / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000188:drug therapy; D008080:Liposarcoma / Q000188:drug therapy*; D012509:Sarcoma / Q000188:drug therapy; D044005:Tetrahydroisoquinolines / Q000627:therapeutic use*; D000077606:Trabectedin
D018906:Antineoplastic Agents, Alkylating; D004149:Dioxoles; D044005:Tetrahydroisoquinolines; D000077606:Trabectedin
ET-743; liposarcoma; metastatic liposarcoma; soft tissue sarcoma; trabectedin; unresectable liposarcoma