What is Sacituzumab Govitecan: Uses, Dosage, Side Effects and More

Sacituzumab govitecan is a targeted cancer medication that combines an antibody with chemotherapy to fight specific types of cancer. This innovative treatment works like a guided missile, delivering chemotherapy directly to cancer cells while trying to spare healthy tissue from damage.

You might be reading this because your doctor has mentioned this medication as a treatment option, or perhaps you're researching on behalf of someone you care about. Understanding how this medication works can help you feel more prepared for conversations with your healthcare team.

What is Sacituzumab Govitecan?

Sacituzumab govitecan is what doctors call an antibody-drug conjugate, which means it's actually two medicines working together as one. The first part is an antibody that seeks out cancer cells, and the second part is a chemotherapy drug that gets delivered directly to those cells.

Think of it like a delivery system where the antibody acts as the address label, finding cells with a specific protein called TROP-2 on their surface. Most cancer cells have lots of this protein, while healthy cells have much less. Once the antibody finds its target, it releases the chemotherapy drug right where it's needed most.

This targeted approach helps reduce some of the side effects you might experience with traditional chemotherapy, though it doesn't eliminate them entirely. The medication goes by the brand name Trodelvy and requires administration through an IV in a healthcare setting.

What is Sacituzumab Govitecan Used For?

Sacituzumab govitecan treats certain types of advanced breast cancer and bladder cancer when other treatments haven't worked or have stopped working. Your doctor will only recommend this medication if your cancer has specific characteristics that make it likely to respond.

For breast cancer, it's typically used for triple-negative breast cancer that has spread to other parts of the body. Triple-negative means the cancer cells don't have receptors for estrogen, progesterone, or HER2 protein, making them harder to treat with hormone therapy or targeted drugs.

The medication is also approved for certain types of bladder cancer, specifically urothelial carcinoma that has spread and hasn't responded to other treatments. Your oncologist will test your cancer to make sure it has the right characteristics before recommending this treatment.

This isn't typically a first-line treatment, meaning your doctor will usually try other medications first. However, when those options aren't working, sacituzumab govitecan can offer hope for controlling cancer growth and potentially extending life.

How Does Sacituzumab Govitecan Work?

This medication works through a clever two-step process that targets cancer cells more precisely than traditional chemotherapy. The antibody part of the drug circulates through your bloodstream, searching for cells that display the TROP-2 protein on their surface.

When the antibody finds a cancer cell with TROP-2, it attaches to the cell like a key fitting into a lock. Once attached, the cancer cell pulls the entire drug inside, where the chemotherapy component gets released. This process is called internalization, and it's what makes this treatment more targeted than regular chemotherapy.

The chemotherapy drug that gets released is called SN-38, which works by interfering with the cancer cell's ability to copy its DNA. Without being able to replicate properly, the cancer cell dies. Because healthy cells have much less TROP-2 protein, they're less likely to take up the drug, which helps protect them from damage.

This is considered a moderately strong cancer medication, more potent than some treatments but designed to be more tolerable than traditional high-dose chemotherapy. The targeted delivery system allows for effective cancer treatment while potentially reducing some of the harsh side effects associated with conventional chemotherapy.

How Should I Take Sacituzumab Govitecan?

Sacituzumab govitecan is given through an IV infusion in a hospital or cancer treatment center, never at home. Your healthcare team will handle all the preparation and administration, so you don't need to worry about measuring doses or timing.

The treatment typically follows a specific schedule where you'll receive the infusion on days 1 and 8 of a 21-day cycle. Each infusion takes about 1 to 3 hours, depending on how well you tolerate it. Your first infusion will be given more slowly to watch for any immediate reactions.

You don't need to take this medication with food since it goes directly into your bloodstream. However, eating a light meal before your appointment can help you feel more comfortable during the treatment. Stay well-hydrated by drinking plenty of water in the days leading up to your infusion.

Your doctor will likely prescribe medications to take before each infusion to help prevent nausea and allergic reactions. These pre-medications are important, so make sure to take them exactly as prescribed, even if you're feeling fine.

Plan to have someone drive you to and from your appointments, especially for the first few treatments, as you might feel tired or unwell afterward. Many people find it helpful to bring entertainment like books or tablets, as well as snacks and water for the infusion period.

How Long Should I Take Sacituzumab Govitecan For?

The duration of your treatment depends entirely on how well the medication works for you and how your body tolerates it. Most people continue treatment as long as their cancer isn't growing and the side effects remain manageable.

Your oncologist will monitor your progress closely through regular scans and blood tests, typically every 2-3 cycles. These check-ups help determine whether the treatment is working and if it's safe for you to continue. Some people might receive treatment for several months, while others may need it for a year or more.

Treatment usually continues until one of several things happens: your cancer starts growing again, you experience side effects that become too difficult to manage, or you and your doctor decide to try a different approach. There's no predetermined end date when you start treatment.

If you're responding well to the medication, your doctor might recommend continuing even if you're experiencing manageable side effects. However, if the treatment becomes too difficult to tolerate, there are ways to adjust the dose or timing to make it more comfortable.

Never stop taking this medication without talking to your oncologist first, even if you're feeling better. Cancer treatment requires consistent dosing to be effective, and stopping suddenly could allow your cancer to grow.

What Are the Side Effects of Sacituzumab Govitecan?

Like all cancer medications, sacituzumab govitecan can cause side effects, though not everyone experiences all of them. The most common side effects are manageable with proper support and monitoring from your healthcare team.

Let's start with the side effects that happen most frequently, as these are the ones you're most likely to experience during treatment:

• Nausea and vomiting, which can usually be controlled with anti-nausea medications
• Diarrhea, sometimes severe, which your doctor will monitor closely
• Fatigue that might make you feel more tired than usual
• Low white blood cell counts, which can increase your risk of infection
• Hair loss, which is usually temporary and reversible
• Decreased appetite and possible weight loss
• Rash or skin reactions at the infusion site

Your healthcare team will give you detailed instructions on managing these common side effects and when to call for help.

There are also some less common but more serious side effects that require immediate medical attention. While these don't happen to most people, it's important to know what to watch for:

• Severe diarrhea that leads to dehydration or kidney problems
• Signs of serious infection like fever, chills, or persistent cough
• Unusual bleeding or bruising
• Difficulty breathing or chest pain
• Severe allergic reactions during or after infusion
• Lung inflammation, which can cause shortness of breath and cough

Contact your healthcare team immediately if you experience any of these more serious symptoms, as they may need to adjust your treatment or provide additional supportive care.

Some rare but potentially serious side effects include liver problems, which your doctor will monitor through regular blood tests, and heart rhythm changes. These complications are uncommon, but your medical team will watch for them through routine monitoring.

Who Should Not Take Sacituzumab Govitecan?

Certain people should not receive sacituzumab govitecan due to safety concerns or reduced effectiveness. Your oncologist will carefully review your medical history to determine if this medication is appropriate for you.

You should not receive this medication if you have a known severe allergic reaction to sacituzumab govitecan or any of its components. People with certain genetic variations that affect how their body processes the medication may also need to avoid it or receive modified doses.

Pregnancy is an absolute contraindication, as this medication can cause serious harm to developing babies. If you're pregnant, planning to become pregnant, or breastfeeding, your doctor will discuss alternative treatment options. Both men and women should use effective contraception during treatment and for several months afterward.

People with severe kidney or liver disease may not be good candidates for this treatment, as their bodies might not be able to process the medication safely. Your doctor will run tests to check your organ function before starting treatment.

If you have a history of severe lung disease or breathing problems, your doctor will weigh the risks and benefits carefully, as the medication can sometimes cause lung inflammation. People with serious heart conditions may also need special consideration.

Sacituzumab Govitecan Brand Name

The brand name for sacituzumab govitecan is Trodelvy, manufactured by Gilead Sciences. This is the name you'll see on your treatment paperwork and insurance documents.

Trodelvy is the only brand name available for this medication, as it's still under patent protection. Generic versions aren't yet available, which means the medication can be quite expensive, but many insurance plans and patient assistance programs help cover the cost.

Your healthcare team will work with you to navigate insurance coverage and explore financial assistance options if needed. The manufacturer offers patient support programs that might help reduce your out-of-pocket costs.

Sacituzumab Govitecan Alternatives

Several alternative treatments might be considered if sacituzumab govitecan isn't suitable for you or stops working. The best alternative depends on your specific type of cancer, previous treatments, and overall health.

For triple-negative breast cancer, alternatives might include other antibody-drug conjugates like trastuzumab deruxtecan (if your cancer has low HER2 expression), immunotherapy drugs like pembrolizumab, or traditional chemotherapy combinations. Your oncologist will consider what treatments you've already received when selecting alternatives.

For bladder cancer, other options include different immunotherapy medications like nivolumab or avelumab, targeted therapy drugs, or various chemotherapy combinations. Clinical trials investigating new treatments might also be an option worth exploring.

The choice of alternative treatment depends on many factors including your cancer's specific characteristics, your previous treatment history, and your overall health status. Your oncologist will discuss all available options with you if sacituzumab govitecan becomes inappropriate for your situation.

Is Sacituzumab Govitecan Better Than Other Cancer Medications?

Sacituzumab govitecan offers unique advantages over some other cancer treatments, particularly for people with specific types of advanced cancer. However, whether it's "better" depends on your individual situation and what other treatments you've tried.

Compared to traditional chemotherapy, sacituzumab govitecan often causes fewer severe side effects because it targets cancer cells more specifically. Many people tolerate it better than conventional chemotherapy combinations, experiencing less severe nausea, hair loss, and fatigue.

Clinical trials have shown that sacituzumab govitecan can help people live longer compared to conventional chemotherapy in certain situations. For triple-negative breast cancer, studies suggest it may extend life by several months compared to standard treatment options.

However, it's not necessarily better than all other treatments for every person. Some people might respond better to immunotherapy drugs, while others might do well with different targeted therapies. Your oncologist considers many factors when determining the best treatment sequence for you.

The medication works particularly well for people whose cancers have high levels of the TROP-2 protein, which is why testing is important before starting treatment. This personalized approach helps ensure you receive the treatment most likely to benefit you specifically.