Current questions in soft tissue sarcoma: further steps with Yondelis®

Treatment of advanced soft tissue sarcoma remains a considerable therapeutic challenge. Doxorubicin-based combination therapy produces reasonable objective response rates but this comes at the cost of high associated toxicity in the absence of an overall survival benefit in the first-line setting. When selecting chemotherapeutic options for patients with advanced disease, it is important to define the goals and expectations of treatment. For the majority of patients with refractory soft tissue sarcoma, goals are long-term tumor stabilization with good quality of life. Trabectedin is an excellent choice in these patients. The fifth anniversary of the marketing authorization of Yondelis (R) (PharmaMar S.A., Madrid, Spain; trabectedin) in Europe provides an excellent opportunity to recap current knowledge and see what the future holds with this novel treatment. Trabectedin has made possible new models of care, such as long-term treatment and rechallenge. Its use has also fueled important and necessary debate about the criteria currently used to evaluate tumor response.