The safety and efficacy of trabectedin for the treatment of liposarcoma or leiomyosarcoma

The improvement of molecular knowledge has highlighted the prognostic and predictive significance of histological subtypes in soft tissue sarcoma (STS). Here we focus on trabectedin, a drug characterized by a unique action combining cytotoxic and target effects. We retraced its main steps of development and peculiarities regarding mechanism of action, efficacy and safety especially towards liposarcoma and leiomyosarcoma and we compared it against the leading therapeutic alternatives with the aim to answer some practical questions such as: who and when to treat with trabectedin? For how long? What is the safety profile? When should trabectedin be preferred to other treatment options? Finally, we provided our viewpoint on how the scenario might evolve in the coming years particularly about the ‘place’ of trabectedin in the therapeutic algorithm and its future possible use in combination with other agents in order to achieve even more satisfactory results in STS management.