Hepatic and hematologic toxicity associated with trabectedin treatment

Background: Trabectedin is an antineoplastic agent indicated for ovarian carcinoma and soft-tissue sarcoma (STS). Objective: Evaluation of trabectedin toxicity profile in clinical practice. Method: Retrospective observational study. Patients who received trabectedin since September 2007 until Mach 2013 were included. Assessment of hepatic toxicity included liver enzymes, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase and alkaline phosphatase. Hematologic toxicity was evaluated through white blood cells, platelets and haemoglobin. Actions that were taken in patients who experienced some kind of toxicity were identified. Results: Twenty-seven patients received trabectedin during study. Hematologic toxicity was treatment limiting, observing grade 3-4 neutropenia in 10 patients and grade 3-4 anaemia in eight. Grade 3-4 increase in AST and ALT was observed in four and six patients. Liver function alterations did not suppose trabectedin dose change or cycle delivery. Conclusions: Hematologic toxicity is the limiting toxicity during trabectedin treatment. Hepatic toxicity is in most cases manageable and reversible