Trabectedin在婦癌治療的應用

The role of trabectedin for gynecologic malignancy

Trabectedin乃一種由海鞘中提煉出來的烷化物，其主要抗癌功用為干擾DNA轉錄作用，以及有選擇性抗消炎和免疫調整作用，能抑制腫瘤細胞的生長、血管增生和轉移。對無法切除、轉移性惡性平滑肌肉瘤或脂肪肉瘤患者經含anthracycline化學治療失敗後可用，歐盟最早認同、後來70個家及美國食品藥物管理局亦通過可以trabectedin治療之，更且，在BRCA基因突變患者，效果尤佳，故最近紛紛採合併trabectedin和pegylated liposomal doxorubicin來治療platinum靈敏的卵巢癌患者。

Trabectedin is an alkylating agent, derived from a marine organism, whose main anti-tumor effect is the result of DNA transcription interference. It also has selective anti-inflammatory and immunomodulatory properties because of the inhibition of factors that promote tumor growth, angiogenesis and metastasis. Initially approved in European Union and in over 70 countries across the world finally for the treatment unresectable or metastatic leiomyosarcoma or liposarcoma after failure of previous standard anthracycline-based chemotherapy, trabectedin was also approved by the US Food and Drug Administration. In addition, BRCA mutational status was found as an important predictor of response to trabectedin therapy. Recently, trabectedin in combination with pegylated liposomal doxorubicin is approved in the European Union and many other countries for treatment of patients with recurrent platinum-sensitive ovarian cancer.