Sacituzumab govitecan (Trodelvy)

Mechanism of action

From the NCI Drug Dictionary: An antibody-drug conjugate containing the humanized monoclonal antibody, hRS7, against tumor-associated calcium signal transducer 2 (TACSTD2 or TROP2) and linked to the active metabolite of irinotecan, 7-ethyl-10-hydroxycamptothecin (SN-38), with potential antineoplastic activity. The antibody moiety of sacituzumab govitecan selectively binds to TROP2. After internalization and proteolytic cleavage, SN-38 selectively stabilizes topoisomerase I-DNA covalent complexes, resulting in DNA breaks that inhibit DNA replication and trigger apoptosis.

Diseases for which it is established

Diseases for which it is used

Bladder cancer

History of changes in FDA indication

Breast cancer

2020-04-22: Granted accelerated approval for adult patients with metastatic triple-negative breast cancer who received at least two prior therapies for metastatic disease. (Based on IMMU-132-01)
- 2021-04-07: Granted regular approval for patients with unresectable locally advanced or metastatic triple-negative breast cancer (mTNBC) who have received two or more prior systemic therapies, at least one of them for metastatic disease. (Based on ASCENT)
2023-02-03: Approved for unresectable locally advanced or metastatic hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative (IHC 0, IHC 1+ or IHC 2+/ISH-) breast cancer who have received endocrine-based therapy and at least two additional systemic therapies in the metastatic setting. (Based on TROPiCS-02)

Bladder cancer

2021-04-13: Granted accelerated approval for patients with locally advanced or metastatic urothelial cancer (mUC) who previously received a platinum-containing chemotherapy and either a programmed death receptor-1 (PD-1) or a programmed death-ligand 1 (PD-L1) inhibitor. (Based on TROPHY-U-01)

History of changes in EMA indication

2021-11-22: Initial marketing authorization as Trodelvy.

History of changes in Health Canada indication

2021-09-24: Initial notice of compliance for the treatment of adult patients with unresectable locally advanced or metastatic triple-negative breast cancer (mTNBC) who have received two or more prior therapies, at least one of them for metastatic disease.

Also known as

Code names: IMMU-132, RS7-SN38
Generic name: sacituzumab govitecan-hziy
Brand name: Trodelvy