New results from two large phase 3 trials show that sacituzumab govitecan (Trodelvy) — a targeted cancer therapy — may help people with advanced triple-negative breast cancer (TNBC) live longer without their cancer getting worse.

Both studies found that sacituzumab govitecan, either on its own or combined with the immunotherapy pembrolizumab (Keytruda), significantly improved progression-free survival compared to chemotherapy.

What Is Trodelvy?

Approved by the U.S. Food and Drug Administration (FDA) in 2020, sacituzumab govitecan is an antibody-drug conjugate. This type of treatment delivers chemotherapy directly to cancer cells by targeting a protein called Trop-2, which is found on most TNBC tumor cells. This targeted approach helps limit damage to healthy cells.

Sacituzumab govitecan is already approved for people with locally advanced or metastatic TNBC (TNBC that has spread to other parts of the body) who have tried at least two other treatments. These findings suggest it may offer benefits as a first-line option, earlier in the treatment process.

Study Results: Trodelvy Improves Time Without Disease Progression

In one trial, researchers studied 443 people with PD-L1-positive metastatic TNBC. PD-L1 is a protein used to guide some immunotherapy treatments. About 40 percent of TNBC cases are PD-L1-positive. Around half of participants received sacituzumab govitecan and pembrolizumab, and the other half received chemotherapy and pembrolizumab.

Those given sacituzumab govitecan had:

• 11.2 months of progression-free survival versus 7.8 months in the chemotherapy group
• A 35 percent lower risk of cancer progression
• A longer median duration of response (16.5 months versus 9.2 months)

A separate trial included people with advanced TNBC who were not candidates for immunotherapy either because their tumors were PD-L1-negative or because they were previously treated with immunotherapy. Participants were either given sacituzumab govitecan or chemotherapy. Sacituzumab govitecan alone led to significantly better progression-free survival compared with standard chemotherapy.

Significantly, the trial results show that sacituzumab govitecan helps people with TNBC whether or not their tumors express PD-L1.

No new safety concerns were identified. Side effects included low white blood cell counts, diarrhea, and nausea, which were consistent with those of earlier studies.

What This Means for People Living With TNBC

Triple-negative breast cancer is one of the most aggressive and difficult-to-treat breast cancers. TNBC tends to grow and spread quickly, and options are limited once the cancer becomes metastatic. These new trial results show that sacituzumab govitecan may offer a more effective first-line treatment option — potentially delaying cancer progression and helping people feel better for longer.

The study outcome “represents the first clinically meaningful advance for this patient population in over 20 years versus chemotherapy,” Dr. Dietmar Berger, chief medical officer at Gilead Sciences, said in a statement.

Talk with your oncologist about treatment options if you’re newly diagnosed with metastatic TNBC. These findings may lead to expanded treatment guidelines in the near future.

Learn five ways to feel your best when living with metastatic breast cancer.

Connect With Others Who Understand

On MyBCTeam, people share their experiences with triple-negative breast cancer, get advice, and find support.

Have you tried Trodelvy or other treatments for TNBC? How have they worked for you? Let us know in the comments below.