2
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Wang J, Wang P, Zeng Z, Lin C, Lin Y, Cao D, Ma W, Xu W, Xiang Q, Luo L, Wang W, Shi Y, Gao Z, Zhao Y, Liu H, Liu SL. Trabectedin in Cancers: Mechanisms and Clinical Applications. Curr Pharm Des 2022; 28:1949-1965. [PMID: 35619256 DOI: 10.2174/1381612828666220526125806] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/04/2022] [Indexed: 12/09/2022]
Abstract
Trabectedin, a tetrahydroisoquinoline alkaloid, is the first marine antineoplastic agent approved with special anticancer mechanisms involving DNA binding, DNA repair pathways, transcription regulation and regulation of the tumor microenvironment. It has favorable clinical applications, especially for the treatment of patients with advanced soft tissue sarcoma, who failed in anthracyclines and ifosfamide therapy or could not receive these agents. Currently, trabectedin monotherapy regimen and regimens of combined therapy with other agents are both widely used for the treatment of malignancies, including soft tissue sarcomas, ovarian cancer, breast cancer, and non-small-cell lung cancer. In this review, we summarized the basic information and some updated knowledge on trabectedin, including its molecular structure, metabolism in various cancers, pharmaceutical mechanisms, clinical applications, drug combination, and adverse reactions, along with prospections on its possibly more optimal use in cancer treatment.
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Affiliation(s)
- Jiali Wang
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Pengfei Wang
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Zheng Zeng
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Caiji Lin
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Yiru Lin
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Danli Cao
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Wenqing Ma
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Wenwen Xu
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Qian Xiang
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Lingjie Luo
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Wenxue Wang
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Yongwei Shi
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Zixiang Gao
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Yufan Zhao
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Huidi Liu
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, T2N 4N1, Canada
| | - Shu-Lin Liu
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China.,Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, T2N 4N1, Canada
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3
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Toulmonde M, Brahmi M, Giraud A, Chakiba C, Bessede A, Kind M, Toulza E, Pulido M, Albert S, Guégan JP, Cousin S, Mathoulin-Pélissier S, Perret R, Croce S, Blay JY, Ray-Coquard I, Floquet A, Italiano A. Trabectedin plus durvalumab in patients with advanced pretreated soft tissue sarcoma and ovarian carcinoma (TRAMUNE): an open-label, multicenter phase Ib study. Clin Cancer Res 2021; 28:1765-1772. [PMID: 34965951 DOI: 10.1158/1078-0432.ccr-21-2258] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/12/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Trabectedin has shown pre-clinical synergy with immune-checkpoint inhibitors in pre-clinical models. EXPERIMENTAL DESIGN TRAMUNE is a phase Ib study investigating trabectedin combined with durvalumab trough a dose-escalation phase and two expansion cohorts (soft tissue sarcoma and ovarian carcinoma). Trabectedin was given at three dose levels (1 mg/m2, 1.2 mg/m2 and 1.5 mg/m2) on day 1, in combination with durvalumab, 1120 mg on day 2, every 3 weeks. The primary endpoints were the recommended phase II dose (RP2D) of trabectedin combined with durvalumab and the objective response rate (ORR) as per RECIST 1.1. The secondary endpoints included safety, 6-month progression-free rate (PFR), progression-free survival (PFS), overall survival, and biomarker analyses. RESULTS 40 patients were included (dose escalation: n=9; STS cohort: n=16; ovarian cohort: n=15, 80% platinum resistant/refractory). The most frequent toxicities were grade 1-2 fatigue, nausea, neutropenia, and alanine/aspartate aminotransferase increase. One patient experienced a dose-limiting toxicity at dose level 2. Trabectedin at 1.2 mg/m2 was selected as the RP2D. In the STS cohort, 43% of patients experienced tumor shrinkage, the ORR was 7% (95% CI 0.2 - 33.9) and the 6-month PFR 28.6% (95% CI 8.4-58.1). In the ovarian carcinoma cohort, 43% of patients experienced tumor shrinkage, the ORR was 21.4% (95% CI 4.7 - 50.8) and the 6-month PFR 42.9% (95% CI 17.7 - 71.1). Baseline levels of PD-L1 expression and CD8-positive T-cell infiltrates were associated with PFS in ovarian carcinoma patients. CONCLUSIONS Combining trabectedin and durvalumab is manageable. Promising activity is observed in platinum-refractory ovarian carcinoma patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sabrina Albert
- Clinical research and Epidemiology Unit, Institut Bergonié
| | | | | | | | | | | | - Jean-Yves Blay
- Medecine, Centre Leon Bérard, Univ Claude Bernard, Unicancer
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4
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Romero I, López-Guerrero JA, Pignata S. Real-world experience with trabectedin for the treatment of recurrent ovarian cancer. Expert Rev Anticancer Ther 2021; 21:1089-1095. [PMID: 34128757 DOI: 10.1080/14737140.2021.1941890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: The efficacy and safety of trabectedin/pegylated liposomal doxorubicin (trabectedin/PLD) in patients with recurrent ovarian cancer have been demonstrated in randomized clinical studies. Real-world evidence is a subsequent necessary step for completing information from clinical practice. In the case of trabectedin/PLD, this evidence derives from prospective studies, retrospective analyses, and case series.Areas covered: The present narrative review provides the most relevant data about efficacy and safety of trabectedin/PLD in real-world studies, and the interpretation of the experience with trabectedin/PLD in clinical practice for patients with recurrent ovarian cancer.Expert opinion: Trabectedin/PLD has a proven antitumor activity that is maintained when administered in advanced lines. Trabectedin/PLD in patients who have relapsed between 6 and 12 months have showed comparable survival outcomes than platinum-based regimens. Moreover, the administration of trabectedin/PLD was associated with a positive survival trend after two previous platinum lines and a significantly superior PFS after subsequent platinum-based therapy. Additionally, the activity of trabectedin seems to be increased in patients with BRCA-mutated ovarian cancer. Overall, real-word evidence has confirmed that trabectedin/PLD is an effective and safe non-platinum combination for advanced lines of chemotherapy in patients with platinum-sensitive recurrent ovarian cancer.
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Affiliation(s)
- Ignacio Romero
- outpatient services, Fundación Instituto Valenciano De Oncología, Valencia, Spain
| | | | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
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5
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Kiyuna T, Tome Y, Murakami T, Kawaguchi K, Igarashi K, Miyake K, Miyake M, Li Y, Nelson SD, Dry SM, Singh AS, Russell TA, Elliott I, Singh SR, Kanaya F, Eilber FC, Hoffman RM. Trabectedin arrests a doxorubicin-resistant PDGFRA-activated liposarcoma patient-derived orthotopic xenograft (PDOX) nude mouse model. BMC Cancer 2018; 18:840. [PMID: 30126369 PMCID: PMC6102848 DOI: 10.1186/s12885-018-4703-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 07/30/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Pleomorphic liposarcoma (PLPS) is a rare, heterogeneous and an aggressive variant of liposarcoma. Therefore, individualized therapy is urgently needed. Our recent reports suggest that trabectedin (TRAB) is effective against several patient-derived orthotopic xenograft (PDOX) mouse models. Here, we compared the efficacy of first-line therapy, doxorubicin (DOX), and TRAB in a platelet-derived growth factor receptor-α (PDGFRA)-amplified PLPS. METHODS We used a fresh sample of PLPS tumor derived from a 68-year-old male patient diagnosed with a recurrent PLPS. Subcutaneous implantation of tumor tissue was performed in a nude mouse. After three weeks of implantation, tumor tissues were isolated and cut into small pieces. To match the patient a PDGFRA-amplified PLPS PDOX was created in the biceps femoris of nude mice. Mice were randomized into three groups: Group 1 (G1), control (untreated); Group 2 (G2), DOX-treated; Group 3 (G3), TRAB-treated. Measurement was done twice a week for tumor width, length, and mouse body weight. RESULTS The PLPS PDOX showed resistance towards DOX. However, TRAB could arrest the PLPS (p < 0.05 compared to control; p < 0.05 compared to DOX) without any significant changes in body-weight. CONCLUSIONS The data presented here suggest that for the individual patient the PLPS PDOX model could specifically distinguish both effective and ineffective drugs. This is especially crucial for PLPS because effective first-line therapy is harder to establish if it is not individualized.
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Affiliation(s)
- Tasuku Kiyuna
- AntiCancer Inc., San Diego, CA, USA.,Department of Surgery, University of California, San Diego, CA, USA.,Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
| | - Takashi Murakami
- AntiCancer Inc., San Diego, CA, USA.,Department of Surgery, University of California, San Diego, CA, USA
| | - Kei Kawaguchi
- AntiCancer Inc., San Diego, CA, USA.,Department of Surgery, University of California, San Diego, CA, USA
| | - Kentaro Igarashi
- AntiCancer Inc., San Diego, CA, USA.,Department of Surgery, University of California, San Diego, CA, USA
| | - Kentaro Miyake
- AntiCancer Inc., San Diego, CA, USA.,Department of Surgery, University of California, San Diego, CA, USA
| | - Masuyo Miyake
- AntiCancer Inc., San Diego, CA, USA.,Department of Surgery, University of California, San Diego, CA, USA
| | - Yunfeng Li
- Department of Surgery, University of California, Los Angeles, CA, USA
| | - Scott D Nelson
- Department of Surgery, University of California, Los Angeles, CA, USA
| | - Sarah M Dry
- Department of Surgery, University of California, Los Angeles, CA, USA
| | - Arun S Singh
- Division of Hematology-Oncology, University of California, Los Angeles, CA, USA
| | - Tara A Russell
- Division of Surgical Oncology, University of California, Los Angeles, CA, USA
| | - Irmina Elliott
- Division of Surgical Oncology, University of California, Los Angeles, CA, USA
| | - Shree Ram Singh
- Basic Research Laboratory, National Cancer Institute, Frederick, MD, USA.
| | - Fuminori Kanaya
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Fritz C Eilber
- Division of Surgical Oncology, University of California, Los Angeles, CA, USA.
| | - Robert M Hoffman
- AntiCancer Inc., San Diego, CA, USA. .,Department of Surgery, University of California, San Diego, CA, USA.
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