Sacituzumab Govitecan in Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer
Source : https://ascopubs.org/doi/10.1200/JCO.22.01002
PURPOSE Hormone receptor-positive (HR+) human epidermal growth factor receptor 2-negative (HER2-) endocrine-resistant metastatic breast cancer is treated with sequential single-agent chemotherapy with poor outcomes. Sacituzumab govitecan (SG) is a first-in-class antibody-drug conjugate with an SN-38 payload targeting trophoblast cell-surface antigen 2, an epithelial antigen expressed in breast cancer.
Conclusion: SG demonstrated statistically significant PFS benefit over chemotherapy, with a manageable safety profile in patients with heavily pretreated, endocrine-resistant HR /HER2– advanced breast cancer and limited treatment options.
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Sarah Mougalian, Yale Cancer Center3yrThis is an important study demonstrating the effectiveness of sacituzumab in endocrine resistant HR+ breast cancer. I have seen criticisms of this study, since the PFS in the sacituzumab arm was only 1.5 months longer than treatment of physician's choice, but this is a highly pretreated population with limited treatment options available. So, in my mind, the fact that sacituzumab outperformed standard chemotherapy gives us another treatment option with a novel mechanism of action. The real question is how to sequence sacituzumab with HR+/HER2 low disease, as trastuzumab deruxtecan showed benefit in that population. My practice is generally to use TDXd first (given the hazard ratio in that study and bigger benefit of TDXd) before sacituzumab.