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
• 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 those your body uses to fight disease, that targets a protein commonly found in triple-negative breast cancer and in some hormone receptor-positive breast cancers. The antibody delivers a chemotherapy drug directly to these cancer cells, helping reduce side effects on healthy cells.

How sacituzumab govitecan works

Sacituzumab govitecan is an antibody-drug conjugate, a type of medicine that combines an antibody with a chemotherapy drug. The antibody helps direct the treatment to cancer cells, while the chemotherapy kills them. The chemotherapy component is SN-38, the active form of a chemotherapy drug called irinotecan. 

Antibody-drug conjugates are designed to more precisely target and destroy cancer cells while causing fewer effects on healthy cells. The antibody in sacituzumab govitecan targets Trop-2, a protein that is commonly found in triple-negative breast cancer cells and 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.
• 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 (through an intravenous line or port) 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 (neutropenia)
• 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.

• Your doctor can confirm neutropenia through a blood test. Let your doctor know if you have any signs of infection, such as fever, chills, trouble breathing, coughing, or pain while urinating. If you develop neutropenia, it can sometimes mean changes to your treatment plan. Some people need white blood cell boosters to prevent long periods in which their white blood cell count is low during treatment with sacituzumab govitecan.
• If you get diarrhea while taking sacituzumab govitecan, tell your doctor right away. 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.