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Sacituzumab Govitecan Gains First-Line Ground in TNBC, Falls Short in Early HR+/HER2− Use

SABCS presentations underscore subtype‑specific use requiring careful treatment sequencing.

Overview

  • In ASCENT-03 for immunotherapy‑ineligible advanced triple‑negative breast cancer, sacituzumab govitecan improved progression‑free survival to 9.7 months vs 6.9 with chemotherapy (HR 0.62; P < .001).
  • Patient‑reported outcomes from ASCENT-03 showed maintained physical functioning and broader quality‑of‑life advantages with sacituzumab govitecan despite more gastrointestinal symptoms.
  • In ASCENT-07 for HR‑positive/HER2‑negative disease after endocrine therapy and before chemotherapy, the primary endpoint was not met, with median PFS 8.3 months in both arms by blinded independent review (HR 0.85; P = .130).
  • Overall survival findings remain immature with limited follow‑up and heavy crossover in control arms, including 61% receiving sacituzumab after progression in ASCENT-07, with investigators reporting an early trend favoring the drug.
  • Across studies, higher rates of grade ≥3 adverse events—especially neutropenia and leukopenia—were observed with sacituzumab govitecan compared with chemotherapy.