Sacituzumab govitecan

Sacituzumab govitecan (Trodelvy) is an antibody-drug conjugate, a treatment that pairs a chemotherapy medicine with a targeted therapy. Sacituzumab govitecan is approved to treat:

• Triple-negative breast cancer that:
  • Is metastatic or locally advanced and can't be removed by surgery
  • Has previously been treated with at least two medicines, including one metastatic breast cancer medicine
• Hormone receptor-positive, HER2-negative breast cancer that:
  • Is metastatic or locally advanced and can't be removed by surgery
  • Has previously been treated with hormonal therapy and a minimum of two other treatments for metastatic breast cancer

Sacituzumab govitecan contains an antibody, similar to the cells in your body that attack diseases, that targets a protein that is very common in triple-negative breast cancer. This protein can also be found in some hormone receptor-positive breast cancers. The antibody in sacituzumab govitecan helps deliver a chemotherapy molecule directly to these cancer cells. This helps limit the side effects of the chemotherapy on the healthy cells.

How sacituzumab govitecan works

Sacituzumab govitecan is an antibody-drug conjugate. These medicines include an antibody to direct the treatment to cancer cells and a chemotherapy to kill the cancer cells. The chemotherapy part is SN-38, an activated form of irinotecan.

Antibody-drug conjugates are designed to better target and kill cancer cells and have fewer effects on the healthy cells in your body. The antibody portion of sacituzumab govitecan targets Trop-2, a protein that is highly expressed in triple-negative breast cancer cells. Trop-2 is also expressed in some hormone receptor-positive breast cancer cells.

Who gets sacituzumab govitecan

The Food and Drug Administration approved sacituzumab govitecan to treat the following individuals:

• People who have been diagnosed with triple-negative breast cancer that is metastatic or locally advanced and can't be removed by surgery; they must have received at least two previous lines of treatment, including one metastatic breast cancer treatment
• People who have been diagnosed with hormone receptor-positive, HER2-negative breast cancer that is metastatic or locally advanced and can't be removed by surgery; they must have previously received hormonal therapy and a minimum of two other metastatic breast cancer treatments

How sacituzumab govitecan is given

Sacituzumab govitecan is given by vein once a week on days 1 and 8 of 21-day treatment cycles. For the first session, the infusion takes 3 hours, but if your body handles it well, it can be given in 1 to 2 hours in future appointments. Sacituzumab govitecan is given until the cancer grows again or until severe side effects develop.

Side effects and things to remember

Common side effects with sacituzumab govitecan include:

• Diarrhea
• Low white blood cell count
• Nausea and vomiting
• Fatigue
• Low red blood cell count
• Hair loss
• Constipation
• Rash
• Stomach pain
• Decreased appetite

Sacituzumab govitecan comes with warnings for neutropenia, a decrease in the level of certain white blood cells, and severe diarrhea. Neutropenia is found by your doctor through a blood test and may result in changes to your treatment. You should let your doctor know if you have any signs of infection such as fever, chills, trouble breathing, coughing, or pain while urinating. Tell your doctor immediately if you get diarrhea while taking sacituzumab govitecan. Most cases of diarrhea are resolved with medicine.

Tell your doctor about any medicines you are already taking, any existing medical conditions (especially liver problems). Sacituzumab govitecan is not recommended if you are pregnant or breastfeeding, and women should try not to become pregnant while taking it.

Your doctor, pharmacist, or nurse can help you manage your side effects. You can also read more on our metastatic breast cancer side effects page.