Trabectedin

What is Trabectedin

Trabectedin is an alkylating agent indicated for the treatment of unresectable or metastatic liposarcoma and leiomyosarcoma in patients that had previously received anthracycline-containing chemotherapy.

Neutropenic sepsis, hepatotoxicity, rhabdomyolysis, and cardiomyopathy have been reported with trabectedin use.

Brand Name

Yondelis

Indications

  • soft-tissue sarcoma

Side Effects

  1. anemia
  2. anemia
  3. anorexia
  4. anorexia
  5. arthralgia
  6. asthenia
  7. capillary leak syndrome
  8. cardiomyopathy
  9. cardiomyopathy
  10. constipation
  11. constipation
  12. diarrhea
  13. diarrhea
  14. dyspnea
  15. dyspnea
  16. elevated hepatic enzymes
  17. elevated hepatic enzymes
  18. fatigue
  19. fatigue
  20. headache
  21. headache
  22. heart failure
  23. hepatic failure
  24. hyperbilirubinemia
  25. hyperbilirubinemia
  26. hypoalbuminemia
  27. hypoalbuminemia
  28. hypoesthesia
  29. insomnia
  30. insomnia
  31. malaise
  32. myalgia
  33. nausea
  34. nausea
  35. neutropenia
  36. neutropenia
  37. paresthesias
  38. peripheral edema
  39. peripheral edema
  40. peripheral neuropathy
  41. pulmonary embolism
  42. renal failure (unspecified)
  43. rhabdomyolysis
  44. thrombocytopenia
  45. thrombocytopenia
  46. vomiting
  47. vomiting

Monitoring Parameters

  • CBC with differential
  • creatine phosphokinase (CPK)
  • ejection fraction
  • LFTs
  • pregnancy testing

Contraindications

  • bone marrow suppression
  • breast-feeding
  • capillary leak syndrome
  • cardiac disease
  • cardiomyopathy
  • chemotherapy
  • contraception requirements
  • extravasation
  • fungal infection
  • geriatric
  • heart failure
  • hepatic disease
  • hepatotoxicity
  • herpes infection
  • infection
  • infertility
  • male-mediated teratogenicity
  • neutropenia
  • pregnancy
  • pregnancy testing
  • radiation therapy
  • reproductive risk
  • rhabdomyolysis
  • ventricular dysfunction
  • viral infection

Interactions

  • Aldesleukin, IL-2
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Apalutamide
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Boceprevir
  • Bosentan
  • Carbamazepine
  • Ceritinib
  • Chloramphenicol
  • Clarithromycin
  • Cobicistat
  • Conivaptan
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enzalutamide
  • Flutamide
  • Fosamprenavir
  • Fosphenytoin
  • grapefruit juice
  • Idelalisib
  • Indinavir
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ketoconazole
  • Letermovir
  • Lopinavir; Ritonavir
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Mifepristone
  • Mitotane
  • Nefazodone
  • Nelfinavir
  • Ombitasvir; Paritaprevir; Ritonavir
  • Palifermin
  • Penicillamine
  • Pentobarbital
  • Phenobarbital
  • Phenytoin
  • Posaconazole
  • Primidone
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifampin
  • Ritonavir
  • Saquinavir
  • St. John’s Wort, Hypericum perforatum
  • Telaprevir
  • Telithromycin
  • Tipranavir
  • Tuberculin Purified Protein Derivative, PPD
  • Tucatinib
  • Voriconazole
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