II. Indications: Advanced Lesions (previously treated with other Chemotherapy)

III. 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

IV. Pharmacokinetics

  1. Metabolism: CYP3A

V. Medications

  1. Lypholized powder for injection solution: 1 mg vial

VI. 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

VII. Adverse Effects

  1. Severe Neutropenia
  2. Rhabdomyolysis
  3. Hepatotoxicity
  4. Cardiomyopathy

VIII. 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

IX. Drug Interactions

  1. Strong CYP3A Inhibitors
    1. Raise Trabectedin levels
  2. Strong CYP3A Inducers
    1. Lower Trabectedin levels

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Related Studies

Ontology: trabectedin (C1311070)

Definition (NCI_NCI-GLOSS) A substance that comes from a type of sea squirt and is being studied in the treatment of cancer. It binds to DNA and causes breaks in the DNA. It also blocks the ability of the cell to repair the DNA damage, and may cause cancer cells to die. Trabectedin is also made in the laboratory. It is a type of DNA excision repair inhibitor.
Definition (NCI) A tetrahydroisoquinoline alkaloid isolated from the marine tunicate Ecteinascidia turbinata with potential antineoplastic activity. Binding to the minor groove of DNA, trabectedin interferes with the transcription-coupled nucleotide excision repair machinery to induce lethal DNA strand breaks and blocks the cell cycle in the G2 phase.
Definition (PDQ) A tetrahydroisoquinoline alkaloid isolated from the marine tunicate Ecteinascidia turbinate. Trabectedin, also known as ecteinascidin 743 (ET743), exhibits potent tumor cytotoxicity by prolonging the G2-M phase of the cell cycle. This agent interacts with the transcription-coupled nucleotide excision repair machinery to induce lethal DNA strand breaks. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42577&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42577&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1691" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C099150
SnomedCT 432214004, 433127001
English Trabectedin, Trabectedin (product), Trabectedin (substance), trabectedin, TRABECTEDIN
Spanish trabectedina (producto), trabectedina (sustancia), trabectedina