Trabectedin in the treatment of patients with soft tissue sarcoma

Soft tissue sarcomas (STS) are rare malignant tumours derived from connective tissue. They constitute about 1% of malignancies occurring in adults. We distinguish over 60 subtypes of soft tissue sarcoma, each with a unique clinical course and a diversified response to systemic treatment. The prognosis for patients with locally advanced, unresectable or metastatic disease remains poor. For years, doxorubicin — used alone or in combination with ifosfamide — has been the basis of treatment for these patients. Trabectedin is a relatively new molecule registered in the treatment of patients diagnosed with STS. The drug was originally obtained from marine tunicates (Ecteinascidia turbinata), currently it is obtained semi-synthetically. So far, a number of potential mechanisms of trabectedin have been descri­bed, including DNA-binding, disruption of DNA repair mechanisms and cell cycle, as well as effects on transcription factors and the tumour microenvironment. The aim of the following review is to summarize the current knowledge on the efficacy and safety of trabectedin in the treatment of patients diagnosed with STS