Trodelvy (Sacituzumab Govitecan-Hziy) for Breast Cancer

What Members Say Top Tips Side Effects Copay Help FAQs

Trodelvy (sacituzumab govitecan-hziy) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with certain types of breast cancer.

What Members Say

MHT logo These insights are based on 169 comments about Trodelvy from MyBCTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.

Benefits:

Scans sometimes show tumor shrinkage or stable disease during treatment.
Benefit can last months, and some stay on treatment for a year or longer.
Dose or schedule adjustments can help treatment continue when side effects are difficult.

Considerations:

Low white blood cell counts can be serious and need regular blood count monitoring.
Premedications can be burdensome, especially steroids, headaches, and sleep disruption.
Fever, dehydration, dizziness, and severe digestive symptoms sometimes need urgent medical attention.

How Trodelvy Works and How It’s Taken

Trodelvy is a type of targeted cancer treatment called an antibody-drug conjugate. It attaches to a protein called Trop-2 that is found on some cancer cells. Once attached, it delivers a chemotherapy medicine into the cancer cell.

This causes DNA damage and leads to cancer cell death. In breast cancer, this may help slow the growth of cancer and destroy cancer cells.

Doctors prescribe Trodelvy when certain adults have advanced breast cancer and have already received other treatments. The exact use depends on the type of breast cancer and the treatments a person has already received. Trodelvy may be used:

Alone for unresectable locally advanced or metastatic triple-negative breast cancer after two or more prior systemic treatments, including at least one treatment for metastatic disease
Alone for unresectable locally advanced or metastatic hormone receptor-positive (HR-positive), human epidermal growth factor receptor 2-negative (HER2-negative) breast cancer after endocrine-based therapy and at least two additional systemic treatments in the metastatic setting

Trodelvy is given through an intravenous (IV) infusion. It is usually given on day 1 and day 8 of a 21-day treatment cycle. Treatment usually continues until the cancer gets worse or side effects become too severe.

Typical Dosing for Breast Cancer

The recommended dose of Trodelvy for breast cancer is 10 milligrams per kilogram of body weight. It is given as an IV infusion once weekly on day 1 and day 8 of each 21-day treatment cycle.

First infusion — The first infusion is usually given over three hours. Individuals should be monitored during the infusion and for at least 30 minutes afterward for signs of an infusion-related reaction.
Later infusions — If earlier infusions are well tolerated, future infusions may be given over one to two hours. Individuals should continue to be monitored during the infusion and for at least 30 minutes after treatment.
Before each infusion — Individuals are usually given medicines before each Trodelvy treatment to help prevent infusion reactions and nausea or vomiting. These medicines may include fever-reducing medicines, antihistamines, steroids for some individuals, and anti-nausea medicines.

Doctors may delay treatment, lower the dose, slow the infusion, temporarily stop treatment, or permanently stop treatment if side effects are severe or difficult to manage.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Trodelvy

MHT logo These insights are based on 169 comments about Trodelvy from MyBCTeam members.

Members who use Trodelvy often say it helps to pay close attention to how your body responds between infusions and to keep your care team updated. They also frequently mention hydration, side effect timing, and asking about dose or schedule adjustments when treatment feels hard to tolerate.

1

Stay hydrated, especially if you feel dizzy or weak.
“I learned by trial and error that I needed to drink a lot more than I felt thirsty for, and at least half of what I drank needed to be a sports drink with electrolytes. My chemo nurses said if it happened again I should come in for some IV hydration.”
2

Learn when side effects are most likely to happen.
“I find that infusion day isn’t bad and the first day after is OK too. It’s about the second to third day in after the infusion that is challenging.”
3

Talk to your doctor about dose or schedule changes.
“I have also adjusted the dosing schedule a few times with a longer period in between infusions. I am a huge advocate of listening to your body.”

Connect with others who understand life with breast cancer. Join MyBCTeam for free.

Trodelvy Side Effects

In clinical studies of Trodelvy for adults with unresectable locally advanced or metastatic breast cancer, the most common side effects occurred in at least 25 percent of people taking Trodelvy.

These side effects include:

Low white blood cell count
Low neutrophil count
Low hemoglobin
Diarrhea
Nausea
Low lymphocyte count
Fatigue
Alopecia (hair loss)
Constipation
Increased glucose
Low albumin
Vomiting
Decreased appetite
Abdominal pain
Decreased creatinine clearance
Increased alkaline phosphatase
Low magnesium
Low potassium
Low sodium

Serious Side Effects and Warnings

Trodelvy can cause serious side effects that may require immediate medical attention. These include:

Severe neutropenia — Very low neutrophil counts can lead to serious or life-threatening infections.
Severe diarrhea — Severe diarrhea can lead to dehydration and kidney problems.
Serious hypersensitivity and infusion-related reactions — These can include severe allergic reactions and anaphylaxis.
Severe nausea and vomiting — Severe nausea or vomiting may require medical attention.
Neutropenic colitis — Inflammation of the colon can occur with very low white blood cell counts.
Increased risk of severe side effects in people with reduced UGT1A1 activity — People with reduced uridine diphosphate-glucuronosyl transferase 1A1 activity may have a higher risk of severe side effects.
Embryo-fetal toxicity — Trodelvy can harm your baby if you are pregnant.

Get medical help right away if you think you are having a serious reaction.

How To Save on Trodelvy

Gilead Sciences, the manufacturer of Trodelvy, offers the Gilead Oncology Co-Pay Program through Gilead Oncology Support. Eligible people with commercial or private insurance may pay as little as $0 out of pocket for Trodelvy.

If you have government insurance or no insurance, Gilead Oncology Support provides information on other potential financial assistance options. The program can also help you understand your insurance coverage and identify available support resources.

To learn more, visit the Trodelvy financial assistance page or call 844-876-3358. Additional information is available from Gilead Oncology Support.

What To Know Before Taking Trodelvy

Before starting treatment, your healthcare provider should check if you are pregnant if you can become pregnant.

Tell your doctor if you have had a severe hypersensitivity reaction to sacituzumab govitecan-hziy. Do not take Trodelvy if you have had a severe hypersensitivity reaction to Trodelvy.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Before starting Trodelvy, tell your doctor about all of your medical conditions, including if you:

Have been told you carry the UGT1A1*28 gene variant. People with this gene variant may have a higher risk of certain side effects, including low white blood cell counts, fever with low white blood cell counts, and low red blood cell counts.
Have liver problems

Trodelvy can harm your baby if you are pregnant.

Females who can become pregnant should use effective birth control during treatment and for six months after the last dose.
Males with female partners who can become pregnant should use effective birth control during treatment and for three months after the last dose.
Tell your doctor right away if you become pregnant during treatment.

Do not breastfeed during treatment with Trodelvy and for one month after the last dose.

Trodelvy may affect fertility in females who can become pregnant. Talk with your doctor if fertility is a concern for you.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Trodelvy?

The effectiveness of Trodelvy can vary from person to person. In clinical studies, Trodelvy helped some people live longer and slowed the growth of their cancer.

In a clinical study of people with unresectable locally advanced or metastatic triple-negative breast cancer who had already received at least two prior chemotherapy treatments (ASCENT study), people treated with Trodelvy lived a median of 11.8 months, compared with 6.9 months for those who received single-agent chemotherapy.

The median progression-free survival (the length of time before the cancer grew or spread) was 4.8 months with Trodelvy and 1.7 months with chemotherapy.

In another clinical study of people with metastatic triple-negative breast cancer (IMMU-132-01 study), 33.3 percent of individuals had their tumors shrink after treatment with Trodelvy. This included 2.8 percent of individuals who had a complete response (no detectable signs of cancer after treatment).

The median duration of response (how long the treatment continued to work after the cancer responded) was 7.7 months.

How often is Trodelvy taken for breast cancer?

Trodelvy is usually given once a week on day 1 and day 8 of a 21-day treatment cycle. The recommended dose is 10 milligrams per kilogram of body weight and is given through an IV infusion. Treatment continues until the cancer gets worse or side effects become too severe.

The first infusion is usually given over three hours. If earlier infusions are well tolerated, later infusions may be given over one to two hours. Individuals are monitored during the infusion and for at least 30 minutes afterward for signs of infusion-related reactions.

Before each infusion, individuals are usually given medicines to help prevent infusion reactions and nausea or vomiting.

Can Trodelvy cause hair loss in breast cancer treatment?

Yes. Alopecia (hair loss) is a common side effect of Trodelvy.

In clinical studies of breast cancer treatment:

Hair loss occurred in 47 percent of people with metastatic triple-negative breast cancer who were treated with Trodelvy (ASCENT study).
Hair loss occurred in 48 percent of people with HR-positive, HER2-negative metastatic breast cancer who were treated with Trodelvy (TROPiCS-02 study).

Not everyone who takes Trodelvy will experience hair loss, but it was one of the most commonly reported side effects in clinical studies. If you are concerned about hair loss during treatment, talk with your healthcare team about ways to manage it.