Probably insignificant hepatic exposure. No capacity for CYP-induction or irreversible CYP-inhibition. Side effects such as nausea, anorexia and vomiting may be potentially porphyrinogenic through reduction in caloric intake.

A tetrahydro-isoquinoline originally extracted from the marine tunicate Ectinascidia turbinata, now manufactured synthetically.

Trabectedin is a DNA-binding agent used for the treatment of advanced soft-tissue sarcomas. Administered as an intravenous infusion. Common adverse reactions of trabectedin that can be confused with an acute porphyric attack are vomiting, nausea, obstipation, abdominal pain, peripheral neuropathy, paraesthesia and insomnia. Side effects such as nausea, anorexia and vomiting may be potentially porphyrinogenic through reduction in caloric intake.

Therapeutic plasma levels are typically less than 10 nM (EMEA, 2007), therefore hepatic exposure is insignificant.

Trabectedin is oxidatively metabolized primarily by CYP 3A4. Other P450 enzymes may contribute to metabolism. Trabectedin does not induce or inhibit major cytochrome P450 enzymes.