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Trabectedin (Yondelis)

This page tells you about the chemotherapy drug trabectedin. It is also called by its brand name Yondelis. There is information about

 

What trabectedin is

Trabectedin is a chemotherapy drug used to treat

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 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 just before your course of treatment starts and it stays in place as long as you need it.

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.

There is detailed information about the way doctors plan chemotherapy in the planning chemotherapy section.

The side effects associated with trabectedin are listed below. You can use the links to find out more about each side effect. For general information, see our cancer drugs side effects section.

 

Common side effects

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

A temporary drop in the number of blood cells made by the bone marrow, causing

Some of these side effects can be life threatening, particularly infections. You should contact your doctor or nurse if you have any of these effects. Your doctor will check your blood counts before and during your treatment to see how well your bone marrow is working.

Other common side effects include

  • Tiredness (fatigue) during and after treatment – most people find that they are back to normal after about 6 months
  • Weakness and loss of strength
  • Feeling or being sick happens in about 7 out of every 10 people (70%), but is usually well controlled with anti sickness medicines – let your doctor or nurse know if your sickness is not controlled
  • Headaches in 1 in 4 people (25%)
  • Taste changes
  • Constipation 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 happens in 1 out of 5 people (20%)
  • Indigestion (heartburn)
  • Liver changes – you may have medicines to protect your liver and will have regular blood tests to check how well your liver is working. 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 in 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 – some people may not be able to have children after trabectedin treatment. It is important to talk to your doctor before starting treatment if you plan to have a baby in the future. Men may be able to store semen 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 and usually goes within a few months of finishing treatment
  • 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 fluid and tell your doctor if it becomes severe, or continues for more than 3 days
  • Hair thinning
  • Pain in your back, muscles or joints – let your doctor or nurse know straight away if this happens
  • 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 regular blood tests to check how well your kidneys are working and will have fluids to flush the drugs through
  • Fluid retention – 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
  • 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
 

Important points to remember

You won’t get all these side effects. Any that you do get may be mild. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on

  • How many times you've had a drug before
  • Your general health
  • How much of the drug you have (the dose)
  • Other drugs you are having

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.

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

Some drugs or herbal medicines may make trabectedin work less well. These include

  • Some antibiotics
  • Some anti epileptic drugs
  • St John's wort

Some drugs may increase the effects of trabectedin. These include

  • Some medicines to treat fungal infections
  • Some medicines for HIV/AIDS
  • Some antibiotics
  • Some anti sickness medicines
  • Some drugs that lower immunity 
  • Drugs for high blood pressure and heart conditions

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

Trabectedin may have a harmful effect on a baby developing in the womb. Talk to your doctor or nurse about contraception before 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.

Breastfeeding is not advisable during this treatment because the drug may come through in the breast milk.

 

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: 17 May 2013