Trabectedin (Yondelis) | Cancer Research UK
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What trabectedin is

Trabectedin is a chemotherapy drug and it a treatment for 

  • Advanced soft tissue sarcoma for people who have had treatment with ifosfamide and an anthracycline chemotherapy such as doxorubicin
  • Ovarian cancer that has come back – in combination with another chemotherapy drug called liposomal doxorubicin
 

How trabectedin works

Trabectedin works by sticking to the DNA in cells and damaging it. This stops the cancer cells growing and multiplying.

 

How you have trabectedin

You have trabectedin into your bloodstream (intravenously). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.

You can read our information about having chemotherapy into a vein.

You usually have chemotherapy as a course of several cycles of treatment. The number of cycles of treatment you have depends on your treatment plan. The treatment plan for trabectedin depends on which type of cancer you have.

For soft tissue sarcoma you have trabectedin through a drip for 24 hours. Once the drip has finished you have no treatment for 3 weeks. Then you have your next treatment.

For ovarian cancer you have the drip for 3 hours the first time. If this goes well you can have the next treatment over an hour. You have treatment every 3 weeks.

You usually continue having the trabectedin for as long as it works.

If you are having trabectedin with liposomal doxorubicin you will have dexamethasone (a steroid). This helps reduce sickness and also protects the liver from damage.

 

Tests during treatment

You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

 

About side effects

We've listed the side effects associated with trabectedin below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.

You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on

  • How many times you've had the drug before
  • Your general health
  • The amount of the drug you have (the dose)

The side effects may be different if you are having trabectedin with other drugs.

Tell your doctor or nurse straight away if any of the side effects get severe.

 

Common side effects

More than 10 in every 100 people have one or more of the side effects listed below.

  • An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae) – let your doctor or nurse know straight away if you have this
  • Tiredness and weakness (fatigue) during and after treatment – most people find that they are back to normal after about 6 months
  • Feeling or being sick happens in about 7 out of every 10 people (70%). It is usually well controlled with anti sickness medicines. Let your doctor or nurse know if your sickness is not controlled
  • Headaches occur in more than 2 out of 10 people (20%)
  • Taste changes
  • Constipation happens in just over 3 out of 10 people (30%) – your doctor may give you laxatives to help prevent this but do tell them if you are constipated for more than 3 days
  • Loss of appetite occurs in 1 out of 5 people (20%)
  • Liver changes – you may have medicines to protect your liver. Let your doctor or nurse know straight away if you have yellowing of the skin or whites of the eyes
  • Shortness of breath and a cough affect just over 1 in 10 people (10%)
  • Severe muscle pain or weakness – this can be due to muscle damage and can lead to kidney damage so let your doctor or nurse know straight away if you have this
  • Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
  • Hand foot syndrome – soreness and redness of the palms of the hands and soles of the feet
 

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these.

  • Numbness or tingling in fingers and toes that can cause difficulty with fiddly things such as doing up buttons. This starts within a few days or weeks. It usually goes within a few months of finishing treatment
  • Nerve damage that can cause pain in your back, muscles and joints, or weakness and numbness. You may have general swelling and a sensation of creeping on the skin – let your nurse know straight away if you have this
  • A very sore mouth – let your nurse know as they can give you mouthwashes or painkillers to help
  • Diarrhoea affects up to 1 out of 10 people (10%) – drink plenty of fluids and tell your nurse if it becomes severe, or continues for more than 3 days
  • Hair thinning
  • Indigestion (heartburn)
  • Swelling of the arms and legs and a sensation of creeping on the skin – let your doctor or nurse know straight away if this happens
  • Kidney changes – you will have fluids to flush the drugs through
  • Fluid build up – your ankles may swell and you may put on weight
  • Inflammation of the lining of the digestive system causing abdominal pain
  • Weight loss
  • Taste changes
  • Coughing
  • Dizziness – don't drive or operate machinery if you have this
  • Difficulty sleeping
  • Low blood pressure
  • Hot flushes
  • Inflammation around the drip site caused by the drug leaking into the tissues. Tell your nurse or doctor straight away if you have any stinging or burning, leakage of fluid, or redness or swelling around your drip site during or after treatment
  • Skin darkening or a rash
 

Rare side effects

Fewer than 1 in 100 people have these effects.

  • Difficulty breathing 
  • An irregular heart beat
  • Reduced amounts of urine
  • Sudden changes in mood
  • Areas of mottled skin
  • Very low blood pressure
 

Important points to remember

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Other medicines

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment. Women need to use reliable contraception during treatment and for 3 months afterwards. Men should use reliable contraception during treatment and for 5 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Do not breastfeed during this treatment because the drug may come through in the breast milk.

Alcohol

It is important not to drink alcohol while having trabectedin treatment as this may cause damage to the liver. 

 

Immunisations and chemotherapy

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.

 

More information about trabectedin

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.

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Updated: 29 April 2015