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In which scenarios would you utilize sacituzumab govitecan earlier than third line in the treatment of metastatic TNBC?

Given seemingly improved efficacy in ASCENT patients who had less prior treatment, would you consider use after only one prior agent rather than two? What is your typical preference for sequencing of agents?
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When would you generally plan to use sacituzumab govitecan in treatment of mTNBC?

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4 Answers
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Medical Oncology · Mayo Clinic Rochester
Answered on

To date, we do not have a head-to-head comparison of sacituzumab govitecan prior to the 3rd line setting and insurance approval for sacituzumab govitecan prior to 3rd can be a barrier. However, I consider it under the following circumstances:

  • The patient has significant pre-existing neuropathy. Many...

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Medical Oncology · UCLA
Answered on

The FDA approval of sacituzumab govitecan is for patients with metastatic TNBC who have received two prior lines of therapy, at least one in the metastatic setting. So, for a patient who received (neo)adjuvant chemotherapy and then had disease recurrence and received 1st line therapy with chemothera...

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Medical Oncology · Sarah Cannon Research Institute
Answered on

Sacituzumab is approved for patients with metastatic TNBC that have received at least 2 prior lines. However, the FDA specifies only one of these lines needs to be for metastatic disease – so we do have a bit of wiggle room here to use 2nd line. The place where I would be thinking of moving sacituzu...

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Medical Oncology · URMC
Answered on

Have been using second-line when possible after first-line chemo. Might consider first-line for patients who have disease relapse within 6 months of adjuvant/neoadjuvant chemotherapy.

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