Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Trabectedin
Drug ID BADD_D02253
Description Trabectedin, also referred as ET-743 during its development, is a marine-derived antitumor agent discovered in the Carribean tunicate _Ecteinascidia turbinata_ and now produced synthetically. Trabectedin has a unique mechanism of action. It binds to the minor groove of DNA interfering with cell division and genetic transcription processes and DNA repair machinery. It is approved for use in Europe, Russia and South Korea for the treatment of advanced soft tissue sarcoma. It is currently under evaluation for the treatment of breast cancer, prostate cancer, in addition to pediatric sarcomas. Both the European Commission and the U.S. Food and Drug Administration (FDA) have approved trabectedin as an orphan drug in soft tissue sarcomas and ovarian cancer. On October 23, 2015, the FDA approved trabectedin, (as Yondelis), for the treatment of specific soft tissue sarcomas.
Indications and Usage Trabectedin interacts with the minor groove of DNA and alkylates guanine at the N2 position, which bends towards the major groove. In this manner, it is thought that the drug affects various transcription factors involved in cell proliferation, particularly via the transcription-coupled nucleotide excision repair system. Trabectedin blocks the cell cycle at the G2 phase, while cells at the G1 phase are most sensitive to the drug. It also inhibits overexpression of the multidrug resistance-1 gene (MDR-1) coding for the P-glycoprotein that is a major factor responsible for cells developing resistance to cancer drugs. The agent is also thought to interfere with the nucleotide excision repair pathways of cancer cells, suggesting that it could be effective in the treatment of many cancer types including melanoma and sarcoma, as well as lung, breast, ovarian, endometrial and prostate cancers; clinical evaluations are underway in these indications.
Marketing Status Prescription
ATC Code L01CX01
DrugBank ID DB05109
KEGG ID D06199
MeSH ID D000077606
PubChem ID 108150
TTD Drug ID D03RTK
NDC Product Code 42973-310; 54893-0092; 70225-1110; 59676-610; 57884-0033
Synonyms Trabectedin | Yondelis | Ecteinascidin 743 | ET-743 | ET743 | ET 743 | NSC 684766
Chemical Information
Molecular Formula C39H43N3O11S
CAS Registry Number 114899-77-3
SMILES CC1=CC2=C(C3C4C5C6=C(C(=C7C(=C6C(N4C(C(C2)N3C)O)COC(=O)C8(CS5)C9=CC(=C(C=C9CCN8) O)OC)OCO7)C)OC(=O)C)C(=C1OC)O
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Skin hyperpigmentation23.05.01.003--
Somnolence19.02.05.003; 17.02.04.006--
Stomatitis07.05.06.0050.001066%
Syncope24.06.02.012; 17.02.04.008; 02.01.02.008--
Thrombocytopenia01.08.01.0020.007992%Not Available
Urinary tract infection20.08.02.001; 11.01.14.0040.001066%
Vomiting07.01.07.0030.004529%
Weight decreased13.15.01.005--
Neutropenic sepsis11.01.11.006; 01.02.03.007--Not Available
Left ventricular dysfunction02.04.02.011--
Ejection fraction decreased13.14.02.0030.000799%
Deep vein thrombosis24.01.02.003--Not Available
Malignant neoplasm progression16.16.01.005--Not Available
Bone marrow toxicity12.03.01.006; 01.03.03.0040.000799%Not Available
Lymphatic disorder01.09.01.003--Not Available
Musculoskeletal discomfort15.03.04.001--Not Available
Transaminases increased13.03.01.0150.003730%Not Available
Haemorrhage24.07.01.002--Not Available
Angiopathy24.03.02.007--Not Available
Neutropenic infection11.01.08.024; 01.02.03.009--Not Available
Blood alkaline phosphatase increased13.04.02.0040.001066%
Hepatic enzyme increased13.03.01.0190.001066%Not Available
Connective tissue disorder15.06.01.006--Not Available
Haematotoxicity12.03.01.025; 01.05.01.0070.001598%Not Available
Infestation11.09.01.001; 23.09.05.001--Not Available
Lung infection22.07.01.008; 11.01.09.0080.000799%
Malnutrition14.03.02.004--Not Available
Mediastinal disorder22.09.03.001--Not Available
Mental disorder19.07.01.002--Not Available
Decreased appetite14.03.01.005; 08.01.09.0280.002131%
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