Comparison between trabectedin and doxorubicin in soft-tissue sarcomas: a systematic review and meta-analysis

Abstract

Background: This study sought to evaluate the differences between trabectedin and doxorubicin in the treatment of soft-tissue sarcoma (STS).Methods: Multiple databases, including PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure, were searched to retrieve relevant articles. Ultimately, the full text of 10 studies involving the use of trabectedin and doxorubicin in STS were reviewed. Review Manager 5.2 was used to evaluate the heterogeneity of the results of the selected articles. Forest plot, bias, and sensitivity analyses were carried out on the included articles.Results: Ten papers that met the criteria were included in this analysis. STS patients receiving trabectedin had longer progression-free survival than those receiving doxorubicin [overall mean difference (MD) =1.36, 95% confidence interval (CI): 1.04, 1.68, I 2 =6%, fixed-effects model]. The experimental group also had a longer overall survival period than the control group (MD =3.92, 95% CI: 0.23, 7.60, P=0.04 and I 2 =83%, random-effects model), and the experimental group had a better disease control rate than the control group (relative risk =1.2, P=0.03 and I 2 =45%, fixed-effects model). From the publication bias analysis and sensitivity analysis, we can guarantee the results are robust and unbiased.Discussion: Our research showed that STS patients who received trabectedin had better clinical effects and a longer survival time than those who received doxorubicin.

Chemotherapeutic drugs for soft tissue sarcomas: a review

“…Trabectedin was approved in Europe in 2007 for the treatment of advanced STSs with previous anthracycline treatment failure and in the United States in 2015 for the treatment of patients with advanced leiomyosarcoma and liposarcoma with previous anthracycline treatment failure ( Nakamura and Sudo, 2022 ). It is the most studied and widely used chemotherapeutic drug for STSs, in addition to doxorubicin and ifosfamide ( Rastogi and Bakhshi, 2016 ; Dang et al, 2021 ; Le Cesne, 2022 ; Nakamura and Sudo, 2022 ; Wang et al, 2022 ). The ORR of trabectedin monotherapy for STS is 4.7%–14.8%, the median PFS is 2.8–5.9 months, and the median OS is 9.2–21.3 months ( Table 3 ).…”

“…In addition, several studies have demonstrated that the efficacy of trabectedin in the treatment of leiomyosarcoma and liposarcoma at the second- or above-line setting is significantly higher than in other STS subtypes (median PFS 5.1 versus 1.4 months, respectively) ( Rastogi and Bakhshi, 2016 ; Schuetze, 2021 ; Vincenzi et al, 2023 ). Therefore, it is necessary to conduct randomized controlled clinical trials in a first-line setting to compare the activity of trabectedin and doxorubicin in these histological subtypes ( Blay et al, 2014 ; Dang et al, 2021 ).…”

Breaking the Bottleneck in Anticancer Drug Development: Efficient Utilization of Synthetic Biology

“…It is used to treat specific soft tissue sarcomas, such as liposarcoma and leiomyosarcoma. According to a clinical study, treatment with trabectedin produces better efficacy and a longer survival time in soft-tissue sarcoma patients [ 139 ]. Aplidine is produced from the marine microorganism Aplidium albicans , and it has curative effects in acute lymphoblastic leukemia via oxidative stress-mediated JNK and p38 activation and ER stress-mediated incorrect protein folding, triggering rapid apoptosis in cancer cells [ 140 ].…”

Do patients with soft-tissue sarcomas treated with trabectedin have better clinical effects and a longer survival time than those treated with doxorubicin?

“…We read with great interest the recent published study by Dang and colleagues entitled "Comparison between trabectedin and doxorubicin in soft-tissue sarcomas (STS): a systematic review and meta-analysis" (1). They demonstrated that STS patients treated with trabectedin had better clinical effects and a longer survival time than those who treated with doxorubicin.…”