Gupta Explores Sacituzumab Govitecan in Advanced Breast Cancer Treatment

Following discussions on ado-trastuzumab emtansine (T-DM1; Kadcyla) and fam-trastuzumab deruxtecan-nxki (Enhertu; T-DXd), Tanya Gupta, MD, medical oncologist in the Stanford University Department of Medicine, Division of Medical Oncology, discusses sacituzumab govitecan (Trodelvy) and its approval from the FDA in the breast cancer space.

Sacituzumab govitecan is an antibody-drug conjugate approved for both patients with advanced triple-negative breast cancer who have received 2 or more prior systemic therapies, at least 1 of which was in the metastatic setting, and in hormone receptor-positive/HER2-negative advanced disease given prior endocrine therapy and at least 2 additional systemic therapies.

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0:09 | And then finally, of the approved antibody-drug conjugates currently, that brings us to sacituzumab. Sacituzumab govitecan is a Trop-2 directed antibody-drug conjugate, and it is comprised of a monoclonal antibody that binds Trop-2, which is a cell surface antigen that's expressed in greater than 80% of breast cancers. The cytotoxic payload is SN-38, which is a topoisomerase I inhibitor.

0:38 | Sacituzumab is currently approved for patients with advanced triple-negative breast cancer who have received two or more prior systemic therapies, at least one of which was in the metastatic setting. But it's also approved for patients with hormone receptor-positive, HER2-negative advanced disease, among patients who have received endocrine therapy and at least two additional systemic therapies.

1:04 | The ASCENT clinical study [NCT02574455] evaluated sacituzumab as compared to physician's choice of chemotherapy in patients with advanced triple-negative breast cancer, and in that setting, sacituzumab was associated with an improvement in median progression-free survival as well as overall survival. Sacituzumab has also been studied for hormone receptor-positive, HER2-negative advanced breast cancer, and this was in the TROPiCS-02 study [NCT03901339], where sacituzumab was associated with an improvement in median progression-free survival along with median overall survival as compared to physician's choice of chemotherapy.