Overview | Schedule | Side Effects | Monitoring | Tips | Patient Assistance | Emotional Wellness | Drugs | References
Treatment Name: Sacituzumab Govitecan (Trodelvy®)
Sacituzumab Govitecan (Trodelvy®) is a Chemotherapy Regimen for Breast Cancer - metastatic
How does sacituzumab govitecan work?
Sacituzumab govitecan is an antibody that targets breast cancer cells. Once it binds to the breast cancer cell surface, it then enters the inside of the cancer cell. Once inside the cell, the antibody releases a drug called SN-38, which stops the cell from growing and dividing.
Goals of therapy:
Sacituzumab govitecan is typically given after at least two other therapies for breast cancer have been tried. It is given to shrink tumors and decrease symptoms of breast cancer, but is not commonly given with the goal of cure.
How is sacituzumab govitecan therapy for breast cancer given?
- Sacituzumab Govitecan intravenous (I.V.) infusion on Days 1 and 8
- First infusion is given over 3 hours. If well tolerated, subsequent infusions are given over 1 to 2 hours
- After the infusion, you will be watched for any side effects for 30 minutes
Estimated total infusion time for this treatment:
- Up to 4 hours or more for Cycle 1, Day 1; as short as 2 hours for all following treatments if well tolerated
- Infusion times are based on clinical studies, but may vary depending on doctor preference or patient tolerability. Pre-medications and intravenous (I.V.) fluids, such as hydration, may add more time
Sacituzumab govitecan is usually given in an outpatient infusion center, allowing the person to go home afterwards. On occasion, it may be given in the hospital if someone is too sick.
Sacituzumab govitecan is repeated every 21 days. This is known as one Cycle. Each cycle may be repeated until the treatment no longer works or until unacceptable side effects occur. Duration of therapy depends upon response, tolerability, and number of cycles prescribed.
Click here for the common sacituzumab govitecan starting doses.
What are the most common side effects from sacituzumab govitecan (Trodelvy®) for breast cancer?
In clinical studies, the most commonly reported side effects of sacituzumab govitecan (Trodelvy®) are shown here:
- Nausea (67%)
- Low white blood cells [neutropenia] (64%)
- Diarrhea (62%)
- Fatigue (55%)
- Low red blood cells [anemia] (50%)
- Vomiting (49%)
- Hair loss (36%)
- Constipation (34%)
- Decreased appetite (30%)
- Skin rash (28%)
- Stomach pain (25%)
- High blood sugar (24%)
- Back pain (22%)
- Low blood magnesium (21%)
- Headache (21%)
- Pneumonia or sinus infection (21%)
- Dizziness (20%)
- Urinary tract infection [UTI] (20%)
- Cough (19%)
- Shortness of breath (19%)
- Nerve pain (19%)
- Low blood potassium (18%)
- Swelling in arms and legs (16%)
- Joint pain (16%)
- Itching (16%)
- Low blood phosphate (15%)
- Dry skin (14%)
- Trouble sleeping (14%)
- Weight loss (14%)
- Mouth sores (14%)
- Dehydration (13%)
- Fever (12%)
- Weakness (11%)
- Pain in arms or legs (10%)
On average, 3% of patients discontinue treatment due to unacceptable side effects.
Importantly, not all people who experience a side effect from sacituzumab govitecan will experience it in the same way. It may be mild in some or severe in others, depending upon the individual. Everybody is different. Additionally, side effects may vary over time. For some, side effects may be a reason to delay or switch treatment, reduce the dose, or avoid treatment with a certain medication altogether.
Side effects may be treatable when they occur or preventable by taking certain medications before they happen. When medications are taken to prevent a problem, this is known as prophylaxis, or "prophy" for short.
After starting treatment with sacituzumab govitecan, be sure to come back and watch all of the side effect videos shown below. Each of these videos contain valuable information about side effect management that will hopefully help you to both feel better and stay out of the hospital.
Watch videos on common sacituzumab govitecan therapy side effects below
How often is monitoring needed?
Labs (blood tests) may be checked before each treatment. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked to see if treatment is working, if there are concerns for disease progression, or if certain side effects occur. Imaging may include: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue sacituzumab govitecan as planned, reduce the dose of future treatments, delay the next dose until the side effect goes away, or switch to an alternative therapy.
Questions to Ask Your...
A better understanding of your treatments will allow you to ask more questions of your healthcare team. We then hope that with the answers, you will get better results and have greater satisfaction with your care. Because we know it's not always easy to know what questions to ask, we've tried to make it easy for you!
Choose any healthcare provider below to see common questions that you may want to ask of this person. Then, either print each list to bring to your clinic visits, or copy the questions and send them as a message to your healthcare team through your electronic medical record.
What are the most important things to know about sacituzumab govitecan while receiving therapy?
- Premedications such as diphenhydramine (Benadryl®), acetaminophen (Tylenol®), and famotidine (Pepcid®) may be given 30 minutes before treatment starts to help avoid infusion related reactions
- Diarrhea may be treated with atropine injections in the medical setting, both before and/or after the infusion. Diarrhea at home can affect quality of life and is commonly treated with loperamide (Imodium®) purchased over-the-counter at a pharmacy. You may receive special instructions on how to use loperamide for diarrhea caused by sacituzumab govitecan. Tell your doctor immediately of you have severe diarrhea at home or go to an emergency department immediately
- If you experience neutropenic fever after any treatment, filgrastim (Neupogen®) or pegfilgrastim (Neulasta®) may given after each following treatment to stimulate production of white blood cells and help avoid long periods of severe neutropenia
- May cause nausea and vomiting for up to a few days after treatment. Be sure to get a prescription from your doctor for anti-nausea medications such as ondansetron (Zofran®) or prochlorperazine (Compazine®) to take at home if needed
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for metastatic breast cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Sacituzumab Govitecan (Trodelvy®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Sacituzumab Govitecan (Trodelvy®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Sacituzumab Govitecan (Trodelvy®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Sacituzumab Govitecan (Trodelvy®)