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Trabectedin

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Trabectedin, Yondelis, Ecteinascidin 743

  • Indications
  • Advanced Lesions (previously treated with other Chemotherapy)
  1. Soft Tissue Sarcoma
  2. Liposarcoma
  3. Leiomyosarcoma (L-Type)
  • Mechanism
  1. Novel alkyating antineoplastic agent
    1. Tetrahydroisoquinoline alkaloid isolated from the Sea Squirt (Ecteinascidia turbinata)
  2. Binds DNA minor groove
    1. Blocks Nucleotide excision repair
    2. Results in DNA breaks, blocking cell growth and replication
  • Pharmacokinetics
  1. Metabolism: CYP3A
  • Medications
  1. Lypholized powder for injection solution: 1 mg vial
  • Dosing
  1. See other references for disease specific dosing protocols
  2. Administered via Central Line
  3. Premedication with Dexamethasone 20 mg IV given 30 min before infusion
  • Adverse Effects
  1. Severe Neutropenia
  2. Rhabdomyolysis
  3. Hepatotoxicity
  4. Cardiomyopathy
  • Safety
  1. Avoid in Lactation
  2. Avoid in Pregnancy (all trimesters)
    1. Teratogenic
    2. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Creatine Phosphokinase
    3. Liver Function Tests
  • Drug Interactions
  1. Strong CYP3A inhibitors
    1. Raise Trabectedin levels
  2. Strong CYP3A Inducers
    1. Lower Trabectedin levels
  • Resources
  1. Trabectedin
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=472bd78e-be17-4b9d-90f4-9482c3aec9ff