In the absence of a curative treatment for patients with recurrent ovarian cancer, many agents have shown different levels of activity in the control of this disease. Trabectedin is an antineoplastic agent originally derived from the Caribbean marine tunicate Ecteinascidia turbinate. This drug has a new mechanism of action based on DNA minor-groove binding. Following the encouraging results from Phase I and II studies of trabectedin monotherapy or in combination in patients with relapsed ovarian cancer, a Phase III trial investigating the use of trabectedin plus liposomal doxorubicin versus liposomal doxorubicin was launched. This study demonstrated a benefit for the combination in terms of progression-free survival that was consistent with published data of platinum-based regimens. This study has opened up the possibility of effective, nonplatinum, trabectedin-based combination therapy in patients with advanced or recurrent ovarian cancer.