A Trop-2 antibody-drug conjugate for breast cancer
Sacituzumab govitecan
A targeted cancer treatment used for some advanced breast cancers, which delivers chemotherapy directly to cancer cells.
What is Sacituzumab govitecan?
Sacituzumab govitecan is a specialist treatment for certain advanced breast cancers, given as a drip into a vein in a chemotherapy unit. It is an antibody-drug conjugate, meaning an antibody that homes in on a marker called Trop-2 on cancer cells is joined to a chemotherapy medicine, so the chemotherapy is delivered more directly to the cancer. The most important problems to watch for are a severe drop in infection-fighting white cells and severe diarrhoea, both of which can be serious. Reactions during the drip and nausea are also common. It can harm a developing baby, so reliable contraception is essential.
Education and reference only. This is a plain-language guide to Sacituzumab govitecan — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Sacituzumab govitecan is a specialist cancer medicine used to treat some types of advanced or spread breast cancer when other treatments have been tried. It is an antibody-drug conjugate: an antibody that recognises a marker called Trop-2, which is found on many breast cancer cells, is linked to a chemotherapy medicine. This design helps carry the chemotherapy to the cancer cells more directly. It is given as an infusion (a drip) into a vein in repeated cycles, under the care of a cancer specialist team in a chemotherapy unit.
How it works
The antibody part of sacituzumab govitecan attaches to the Trop-2 marker on the surface of cancer cells. Once attached, it is taken inside the cell, where the chemotherapy part is released to damage the cancer cell's DNA and stop it dividing, leading the cell to die. By linking the chemotherapy to an antibody that seeks out cancer cells, the aim is to focus the chemotherapy where it is most needed. Because it still affects fast-dividing healthy cells too, such as those in the bone marrow and gut, it can cause a drop in blood cells and diarrhoea.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist cancer treatment used in the UK for certain advanced breast cancers, given by drip in a chemotherapy unit.
Practical use
How to take Sacituzumab govitecan
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as a drip into a vein in a chemotherapy unit, in repeated cycles set by your cancer team.
- You will usually be given medicines beforehand to reduce nausea and the chance of a reaction during the drip.
- Contact your team urgently if you develop a high temperature, shivering or feel generally unwell, as this can signal a serious infection.
- Tell your team straight away about diarrhoea, and use the anti-diarrhoea advice and medicine they give you to avoid dehydration.
- Use reliable contraception during treatment and for the time afterwards that your team advises, as it can harm a developing baby.
Weighing it up
Advantages & disadvantages of Sacituzumab govitecan
Advantages
- A targeted way to deliver chemotherapy to breast cancer cells carrying the Trop-2 marker.
- An option for some advanced breast cancers after other treatments.
- Given in repeated cycles under close specialist supervision in a chemotherapy unit.
Disadvantages
- Can cause a severe drop in infection-fighting white cells, raising the risk of serious infection.
- Can cause severe diarrhoea, which may lead to dehydration if not managed.
- Commonly causes nausea, tiredness, hair loss and reactions during the drip.
Practical use
Good to know
The two side effects to take most seriously are a severe drop in infection-fighting white blood cells (neutrophils) and severe diarrhoea, both of which can become dangerous if not managed quickly. Because of the white-cell drop, a high temperature, shivering or feeling generally unwell may be the first sign of a serious infection and must be treated as an emergency. Diarrhoea can be severe and lead to dehydration, so your team will give you advice and medicine to manage it and will tell you when to call. Reactions during or soon after the drip, such as flushing, breathlessness or a rash, can happen, so you are watched during treatment and usually given medicines beforehand to reduce nausea and reactions. Hair loss and tiredness are common. As with all cancer treatments of this kind, it can seriously harm a developing baby, so reliable contraception during treatment and for a time afterwards is essential. Blood tests are done regularly to guide each cycle.
Who should not take it / use with caution
- People who have had a serious allergic reaction to sacituzumab govitecan should not receive it.
- It must not be used in pregnancy because it can seriously harm a developing baby.
- It is used with care in people with reduced blood counts, liver problems or an inherited difficulty in clearing the chemotherapy, under specialist guidance.
Monitoring
- Regular blood tests to check infection-fighting cells, red cells and platelets before each cycle.
- Watching for and managing diarrhoea, infection and reactions during treatment.
- Reviewing how the cancer is responding and how well treatment is tolerated.
Side effects
- A severe drop in infection-fighting white blood cells, raising the risk of serious infection.
- Severe diarrhoea, which can cause dehydration if not managed promptly.
- Nausea, vomiting, tiredness, hair loss and a drop in red cells (anaemia).
- Reactions during or soon after the drip, such as flushing, breathlessness or rash, which the team watches for.
Key interactions
- Tell your team about all your medicines, as some can affect how the chemotherapy part is handled by the body.
- Other medicines that lower blood cells or weaken the immune system add to the risk and need careful review.
- Live vaccines are generally avoided during treatment; check with your team before any vaccination.
Available as: A powder made up into a solution for a drip into a vein.
Answers
Sacituzumab govitecan: frequently asked questions
What is sacituzumab govitecan used for?
It is used to treat certain types of advanced or spread breast cancer, delivering chemotherapy to cancer cells that carry a marker called Trop-2.
Why is the white-cell drop so important?
It can lower your infection-fighting white cells severely, so a high temperature or feeling unwell may signal a serious infection and must be treated as an emergency.
Is diarrhoea common?
Yes, and it can be severe. Tell your team early and use the anti-diarrhoea advice and medicine they give you, as severe diarrhoea can cause dehydration.
Will I lose my hair?
Hair loss is common with this treatment; your team can talk you through what to expect and how to manage it.
Can I get pregnant during treatment?
No. It can seriously harm a developing baby, so reliable contraception during treatment and for a time afterwards is essential.
The wider class
About Trop-2 antibody-drug conjugate (targeted chemotherapy)
Sacituzumab govitecan belongs to the trop-2 antibody-drug conjugate (targeted chemotherapy) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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