有关放射治疗（RT）和曲贝特定（trabectedin）协同作用的临床前数据已经报道。探索曲贝特定与放射治疗联合治疗粘液样脂肪肉瘤的疗效和安全性。这项国际性、开放式的非随机、第二阶段临床试验在西班牙的4个中心，意大利的1个中心和法国的2个中心进行，共纳入46名患有局限性可切除性肢体或躯干壁粘液样脂肪肉瘤的患者，时间为2016年7月1日至2019年9月30日。符合条件的患者必须有组织学中心评估的局限性可切除性粘液样脂肪肉瘤诊断。曲贝特定以第一阶段试验建议剂量（1.5 mg/m2）给予静脉输注，每21天给药一次，共3个周期。放射治疗是在完成第一次曲贝特定输注（第1个周期，第2天）后开始的。患者接受25次放射治疗，共45 Gy。手术计划在最后一次术前周期的给药后3到4周进行，并且在术前放射治疗结束4周后才进行。病理标本在肿瘤切片中进行标记，以评估新辅助治疗后的组织学变化和活性肿瘤的百分比。该研究的第二阶段的主要目标是总体反应率。次要目标是以复发无病生存和功能影像和病理反应来衡量其疗效和活性。共招募了46名患者，其中有4名患者无法评估。患者的中位年龄为43岁（范围为18-77岁），31名患者为男性（67％）。总体而言，41名患者中有9名患者（22％）通过新辅助治疗获得了部分反应，而有5名患者（13％）获得了完全病理学反应，39名患者中有20名患者（51％）的活性肿瘤剩余量为10％以下。根据 Choi 标准，29名可评估患者中有24名患者（83％）获得了部分反应，没有患者出现疾病进展。治疗耐受性良好。虽然这项非随机临床试验的主要终点没有达到（Solid Tumors反应评估标准中至少70％的患者反应），但结果表明该联合治疗方案在病理学反应方面具有很好的耐受性和疗效。因此，在耐受性方面，曲贝特定加放射治疗可能是一种治疗选择，但需要在这个领域产生更多的证据。

Preclinical data about the synergistic activity of radiotherapy (RT) and trabectedin have been reported. The combination of trabectedin and RT in treating myxoid liposarcomas appears worth exploring.To explore the effectiveness and safety of trabectedin combined with RT.This international, open-label, phase 2 nonrandomized clinical trial including 46 patients with myxoid liposarcoma was conducted in 4 centers in Spain, 1 in Italy, and 2 in France from July 1, 2016, to September 30, 2019. Eligible patients had to have a histologic, centrally reviewed diagnosis of localized resectable myxoid liposarcoma arising from an extremity or the trunk wall.Trabectedin was administered at the recommended dose stemming from the phase 1 trial (1.5 mg/m2), with intravenous infusion during 24 hours every 21 days for a total of 3 cycles. Radiotherapy was started after completion of the first trabectedin infusion (cycle 1, day 2). Patients received 25 fractions of radiation for a total of 45 Gy. Surgery was planned 3 to 4 weeks after the administration of the last preoperative cycle and not until 4 weeks after the end of preoperative RT. Pathologic specimens were mapped in tumor sections to estimate the histologic changes and the percentage of viable tumor after neoadjuvant treatment.The primary objective of the phase 2 part of the study was overall response. Secondary objectives were effectiveness measured by relapse-free survival and activity measured by functional imaging and pathologic response.A total of 46 patients were enrolled. Four patients were not evaluable. The median age was 43 years (range, 18-77 years), and 31 patients were male (67%). Overall, 9 of 41 patients (22%) achieved a partial response with neoadjuvant treatment with trabectedin and RT, with 5 of 39 patients (13%) achieving a complete pathologic response and 20 of 39 patients (51%) having 10% or less of a viable remaining tumor. Partial responses according to Choi criteria were observed in 24 of 29 evaluable patients (83%), and no patient had disease progression. Treatment was well tolerated.Although the primary end point of this phase 2 nonrandomized clinical trial was not met (Response Evaluation Criteria in Solid Tumors response in ≥70% of patients), results suggest this combination was well tolerated and effective in terms of pathologic response. Thus, trabectedin plus RT might be a treatment option regarding tolerability; further evidence should be generated in this setting.