Background: Despite the growing amount of published data regarding the outcomes of sarcoma patients treated with trabectedin, still some questions remain unanswered. The aim of the ReTraSarc trial (NCT03284320) was to evaluate the efficacy and safety of trabectedin in a large German population. Methods: Patients treated between 2007-2018 were retrospectively analyzed. All patients had histologically confirmed soft tissue (STS; n = 478) or bone (BS; n = 31) sarcoma; either metastatic (n = 468) or locally advanced (n = 41) disease, and had received at least one cycle of trabectedin. Based on follow-up data (until October 2019), progression-free survival (PFS) and overall survival (OS) after initiation of trabectedin treatment were estimated according to the Kaplan-Meier method. Results: A total of 509 patents were analyzed. Patients had a mean age of 54 years for STS and 30 years for BS-patients, and 25.4% of them aged > 65 years. Overall, 71.4% of patients had a good performance status (ECOG 0/1), and 37.7% received two prior lines, 28.3% three and 34% received > 3 prior lines of systemic treatment. Patients received a median of 3 cycles (IQR: 2-6 cycles) of trabectedin. Trabectedin resulted in an objective response rate (ORR) of 10% with a 37.4% of disease control rate (DCR). The median PFS and OS were 2.5 months (IQR: 1.4-6.1 months) and 8.2 months (IQR: 3-21 months), respectively. Significantly more patients with liposarcoma (22.1%; 95% CI: 15.2-32.2) were free from progression at 12 months after treatment as compared with patients with leiomyosarcoma (8.5%; 95% CI: 4.8-14.9). More analyses of effectiveness and safety are in progress (e.g. stratified per sarcoma subtypes or therapeutic line) and will be presented. Conclusions: The results of this real-life study, with a large number of patients and long-term follow-up, allow us to better analyze PFS and OS in sarcoma patients treated with trabectedin, given in different treatment lines and after dose modifications and/or cycle delays. Additionally, the results of this study enable us to evaluate the real-life impact of rechallenge with trabectedin in a further therapy line. Clinical trial information: NCT03284320.