Dr Phadke on the Benefit of Sacituzumab Govitecan in HR+/HER2– Breast Cancer


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Sneha Phadke, DO, MPH, discusses the benefit associated with treatment consisting of the antibody drug conjugates sacituzumab govitecan in hormone receptor-positive/HER2-negative breast cancer.

In an OncLive® State of the Science Summit™, Phadke and colleagues from the Holden Comprehensive Cancer Center presented on topics spanning breast cancer care. Phadke’s presentation focused on the use of ADCs, where she highlighted the use of sacituzumab govitecan. Phadke shares that the main takeaway for from her presentation was that novel ADCs in the treatment armamentarium can be used in lieu of chemotherapy or other systemic therapies.

The ADC sacituzumab govitecan is a topoisomerase 1 inhibitor, which is a part of a class of agents designed to disrupt DNA replication in cancer cells. Sacituzumab govitecan was granted regular approval by the FDA in April 2021 for the treatment of patients with unresectable locally advanced or metastatic triple-negative breast cancer who have previously received 2 or more systemic therapies, at least 1 of them for metastatic disease. Notably, the agent had previously been granted accelerated approval in April of 2020 based on data from the multicenter, open-label, randomized, phase 3 ASCENT trial (NCT02574455).

More recently, the Trop2-directed ADC was evaluated in the HR-positive/HER2-negative setting, Phadke expands. In the phase 3 TROPiCS-02 trial (NCT03901339), the use of sacituzumab govitecan led to a statistically significant and clinically meaningful improvement in overall survival compared with physicians choice of single-agent chemotherapy. In turn, These data led to the FDA approval of the ADC for the treatment of patients with unresectable locally advanced or metastatic HR-positive/HER2-negative breast cancer who have received endocrine-based therapy and at least 2 additional systemic therapies in the metastatic setting.

In her presentation, Phadke also discusses the mechanisms of action of ADCs, compares and contrasts non-cleavable and cleavable linkers, and explains how these can lead to differences in patient outcomes.

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