Name of the Procedure:

Injection, Trabectedin, 0.1 mg (HCPCS Code J9352)

• Common names: Yondelis (brand name), Trabectedin Injection
• Technical terms: Intravenous Trabectedin Administration

Summary

Trabectedin injection is a medical procedure where a specialized chemotherapy drug, trabectedin, is administered intravenously. This treatment is typically used for certain types of cancer, and it is administered under the supervision of healthcare professionals in a clinical setting.

Purpose

Trabectedin is used to treat patients with advanced soft-tissue sarcoma and ovarian cancer. The goal of the injection is to slow down or stop the growth of cancer cells, potentially shrinking tumors and alleviating symptoms associated with these cancers.

Indications

• Advanced or metastatic soft-tissue sarcoma.
• Recurrent ovarian cancer.
• Patients who have failed other treatments or have specific genetic markers that suggest trabectedin could be effective.

Preparation

• Pre-procedure instructions typically include fasting for a few hours before the injection.
• Patients should notify their healthcare provider about any other medications they are taking to avoid potential interactions.
• Blood tests and liver function tests may be required to ensure the patient is fit for the procedure.

Procedure Description

1. The patient arrives at the healthcare facility and is prepped for an intravenous injection.
2. An IV line is inserted into a vein, usually in the arm.
3. Trabectedin is mixed with a saline solution and administered slowly over a period of 24 hours using an infusion pump.
4. The patient is monitored throughout the infusion for any adverse reactions.
5. Post-infusion care includes flushing the IV line to ensure all medication is administered.

Tools/Equipment Used:

• IV line and catheter
• Infusion pump
• Saline solution
• Sterile needles and syringes

Anesthesia/Sedation:

• Typically, no anesthesia is needed, but an anti-nausea medication may be given to manage side effects.

Duration

The trabectedin infusion process typically takes about 24 hours.

Setting

The procedure is performed in a hospital or outpatient clinic setting, often in a chemotherapy suite.

Personnel

• Oncologist or chemotherapy nurse
• Pharmacist (for preparation of the medication)
• Healthcare assistants

Risks and Complications

• Common risks: nausea, fatigue, vomiting, loss of appetite
• Rare risks: severe infections, liver dysfunction, tissue necrosis at the injection site
• Potential complications can include allergic reactions, severe muscle damage, and low white blood cell counts. These are managed by immediate medical intervention and supportive care.

Benefits

• Potential to shrink tumors and control cancer progression
• Relief of cancer-related symptoms
• Improved quality of life and potentially prolonged survival

Recovery

• Post-procedure care involves monitoring for adverse effects and managing symptoms.
• Patients are advised to rest and stay hydrated.
• Recovery time can vary, but most patients return to normal activities within a few days.
• Follow-up appointments are essential to monitor the patient's response to treatment.

Alternatives

• Other chemotherapy drugs
• Radiation therapy
• Surgical options, if feasible
• Participation in clinical trials for new treatments

Pros and Cons:

• Trabectedin may be effective when other treatments have failed, but the side effects can be significant.
• Alternatives could have different efficacy rates and side-effect profiles.

Patient Experience

During the infusion, patients might feel discomfort or mild pain at the IV site. Post-procedure, patients may experience nausea, fatigue, and other side effects, which can be managed with medication. Pain management and supportive measures are provided to ensure patient comfort.