Advanced soft-tissue sarcoma and treatment options: critical appraisal of trabectedin

Ingrid M E Desar,1 Anastasia Constantinidou,2 Suzanne E J Kaal,1 Robin L Jones,2 Winette T A van der Graaf,1,2 1Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands; 2The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, UK Abstract: Soft-tissue sarcomas (STS) are a heterogeneous group of rare solid tumors of mesenchymal origin. This paper reviews the current status of systemic treatment in advanced and metastatic soft tissue sarcomas, with an emphasis on trabectedin. Trabectedin is a unique type of chemotherapeutic agent with multiple potential mechanisms of action. We discuss the putative mechanisms, as well as the toxicity and administration schedules of trabectedin, followed by its efficacy in first-line systemic therapy and beyond first-line systemic therapy. Keywords: soft-tissue sarcoma, trabectedin, chemotherap