Sacituzumab Govitecan Provides More Treatment Options in HER2– Breast Cancer

The FDA’s previous approval of sacituzumab govitecan-hziy (Trodelvy) has opened up new treatment options outside of standard chemotherapy for patients with hormone receptor (HR)–positive or HER2-negative or -low metastatic breast cancer who are endocrine therapy refractory, according to Sara M. Tolaney, MD, MPH.

At the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting, CancerNetwork^® spoke with Tolaney, chief of the Division of Breast Oncology and associate director of the Susan F. Smith Center for Women’s Cancer at Dana-Farber Cancer Institute, and associate professor of medicine at Harvard Medical School, in Boston, about how findings from the phase 3 TROPiCS-02 study’s (NCT03901339) final overall survival analysis further support the benefit of sacituzumab govitecan in this population following the FDA’s approval of the agent in February 2023.^1,2

Data from the analysis highlighted that sacituzumab govitecan improved overall survival in the HER2 IHC0 (Hazard ratio [HR], 0.85; 95% CI, 0.63-1.14) and HER2-low populations vs single agent chemotherapy (HR, 0.75; 95% CI, 0.57-0.97).

Transcript:

It's really exciting to have more treatment options for patients with pretreated metastatic [HR]-positive disease. The data from TROPiCS-02 certainly reinforces that sacituzumab govitecan does have benefit for this population, not just in terms of progression-free survival, but also in terms of a clinically meaningful and significant improvement in survival. It has opened up treatment options.

Many patients who are HER2-low will start off with a line of standard chemotherapy, go on to get [trastuzumab deruxtecan; Enhertu], and then subsequently go on to get sacituzumab. For those patients who are not HER2-low, [who] have a HER2 IHC of 0, and [estrogen receptor]–positive [disease], then we're often turning to sacituzumab even earlier. [Patients] will often get a line of chemotherapy and then go to sacituzumab. [The approval of sacituzumab] is allowing for more choices outside of just standard chemotherapy once people become endocrine refractory, which is great for patients.

References

1. U.S FDA approves Trodelvy in pre-treated HR+/HER2- metastatic breast cancer. News release. Gilead. February 3, 2023. Accessed June 5, 2023. https://bwnews.pr/3Y0bftX
2. Tolaney SM, Bardia A, Marmé F, et al. Final overall survival (OS) analysis from the phase 3 TROPiCS-02 study of sacituzumab govitecan (SG) in patients (pts) with hormone receptor–positive/HER2-negative (HR+/HER2–) metastatic breast cancer (mBC). J Clin Oncol. 2023;41(suppl 16):1003. doi:10.1200/JCO.2023.41.16_suppl.1003