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Sacituzumab Govitecan: Trop-2 Targeted ADC Therapy

SN-38 payload delivered via Trop-2 directed antibody conjugate

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Sacituzumab Govitecan: Trop-2 Targeted ADC Therapy?

Sacituzumab govitecan targets trophoblast cell surface antigen 2 (Trop-2), highly expressed in many epithelial cancers including triple-negative breast cancer.

The hydrolyzable linker enables both intracellular SN-38 release after antigen-mediated internalization and bystander cytotoxicity from extracellular cleavage.

Approved indications include unresectable locally advanced or metastatic triple-negative breast cancer after at least 2 prior systemic therapies, HR-positive HER2-negative metastatic breast cancer after endocrine and chemotherapy and locally advanced or metastatic urothelial cancer.

Trop-2 testing is not currently required for treatment selection in approved indications.

Pharmacokinetics support intravenous administration on days 1 and 8 of 21-day cycles.

Symptoms

Sacituzumab govitecan is a treatment, not a disease; clinical effects depend on the underlying cancer.
Common adverse effects include neutropenia, diarrhea, nausea, fatigue, alopecia and anemia.
Severe diarrhea may occur and requires prompt management with antidiarrheal agents and supportive care.
Hypersensitivity reactions and infusion-related reactions can occur during administration.
Cytopenias including severe neutropenia, febrile neutropenia and thrombocytopenia require monitoring and supportive measures.

Risk Factors

Reduced UGT1A1 activity due to genetic polymorphisms (UGT1A1*28 homozygous) increases risk of severe neutropenia and diarrhea.
Pre-existing hepatic impairment may affect drug metabolism and increase toxicity.
Older patients and those with poor performance status may have increased susceptibility to adverse events.
Pregnancy and breastfeeding are contraindications due to embryofetal toxicity.
Concurrent medications affecting UGT1A1 induction or inhibition can alter drug exposure.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe diarrhea, dehydration or signs of hypovolemia require immediate medical attention.
  • Febrile neutropenia, severe infection or unusual bleeding warrants urgent intervention.
  • Severe hypersensitivity reactions, anaphylaxis or significant infusion reactions need immediate care.
  • Persistent severe nausea, vomiting or inability to maintain oral intake requires assessment.
  • New respiratory symptoms, severe abdominal pain or unexpected neurologic symptoms need prompt evaluation.

Treatment Methods

01
Standard dosing is 10 mg/kg intravenously on days 1 and 8 of 21-day cycles until progression or unacceptable toxicity.
02
Premedication with antiemetics and consideration of corticosteroids and antihistamines for hypersensitivity reactions.
03
Loperamide and supportive measures for diarrhea management; UGT1A1 testing may guide initial dose decisions.
04
Growth factor support may be needed for neutropenia; treatment delays and dose reductions are based on toxicity grade.
05
Combination strategies with immunotherapy, PARP inhibitors and other targeted agents are being investigated; comprehensive supportive care, infection prophylaxis and patient education on recognition of side effects are essential.

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.