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Trabectedin

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Information about Trabectedin

Trabectedin is natural product derived from the Caribbean sea squirt which has antineoplastic activity and is used to treat soft tissue sarcoma. 

Liver safety of Trabectedin

Trabectedin therapy is associated with a high rate of transient serum enzyme elevations during treatment and with occasional instances of clinically apparent liver injury with jaundice.

Mechanism of action of Trabectedin

Trabectedin (tra bek' te din) is a novel antineoplastic agent initially derived from extracts of the Caribbean sea squirt, Ecteinascideia turbinata or mangrove tunicate.  It was the first drug to be isolated from a sea animal.  Trabectedin binds to the minor groove of DNA, allowing for alkylation of guanine and resulting in DNA damage.  Biosynthesis of the active product allowed for clinical trials of trabectedin which demonstrated evidence of cytotoxic activity against soft tissue sarcomas. 

FDA approval information for Trabectedin

Trabectedin was approved for use in the United States in 2014 as therapy of advanced, refractory liposarcoma and leiomyosarcoma.  Trabectedin is given intravenously and is available as 1 mg of lyophilized powder in single use vials under the brand name Yondelis

Dosage and administration for Trabectedin

The typical dose is 1.5 mg/m2 body surface area as a 24 hour infusion every 3 weeks.  It is usually given after premedication with 20 mg of dexamethasone. 

Side effects of Trabectedin

Side effects are common and include bone marrow suppression, nausea, vomiting, diarrhea, anorexia, fatigue, peripheral edema, dyspnea, and headache.  Serious adverse events include neutropenic sepsis, rhabdomyolysis, cardiomyopathy and embryo-fetal toxicity.

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