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Marine-derived alkylating cytotoxic

Trabectedin (Specialist drug)

Brand names: Yondelis

Trabectedin is a marine-derived alkylating cytotoxic agent used under specialist supervision for advanced soft-tissue sarcoma and relapsed platinum-sensitive ovarian cancer.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds the minor groove of DNA, bending the helix and interfering with transcription, DNA repair and the cell cycle, ultimately triggering cell death.

Prescribing in practice

  • Administer only via a central venous line because extravasation causes severe tissue necrosis, and give with corticosteroid premedication to reduce hepatotoxicity and emesis.
  • It is a specialist chemotherapy agent restricted to clinicians experienced in cytotoxic therapy.
  • Hepatic impairment and concomitant CYP3A4 inhibitors increase toxicity and require careful review against the SPC.

Monitoring

Monitor full blood count, liver function and creatine kinase before each cycle and intermittently during treatment.

Counselling the patient

  • Report fever, unusual bruising or bleeding, or dark urine and muscle pain promptly.
  • Effective contraception is required during and for a period after treatment.
  • Injection-site or infusion reactions should be flagged to the team immediately.

Evidence & guidelines

Use is guided by the SPC and NICE technology appraisals for soft-tissue sarcoma and ovarian cancer.

Reference: NICE TA185/TA389; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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