Trodelvy

Trodelvy is the brand name for sacituzumab govitecan, an antibody-drug conjugate (ADC) used in cancer therapy. It consists of a humanized antibody that targets Trop-2, a cell-surface protein commonly overexpressed in various epithelial cancers, linked to SN-38, the active metabolite of irinotecan. The linker is designed to release SN-38 inside cancer cells and in the tumor microenvironment, enabling a cytotoxic bystander effect in neighboring cells.

Mechanism of action centers on Trop-2–targeted binding, internalization of the ADC, and release of SN-38 to disrupt DNA replication and induce cell death. Trop-2 expression is variable across tumors, so the therapy is intended for Trop-2–positive cancers where conventional treatments have limited efficacy.

Regulatory history and indications have included approvals in the United States for adults with metastatic triple-negative breast cancer (TNBC) after at least two prior therapies, based on objective response rates seen in pivotal trials. In addition, Trodelvy has been approved for certain urothelial carcinomas in patients who have progressed after platinum-containing therapy and at least one other regimen. Approvals have varied by country and may expand to other Trop-2–expressing cancers as evidence from ongoing trials accumulates.

Administration and dosing typically involve intravenous infusion of about 10 mg/kg on days 1 and 8 of a 21-day cycle, continued until disease progression or intolerable toxicity. Common adverse effects include neutropenia, diarrhea, nausea, fatigue, and alopecia, with additional risks of febrile neutropenia and interstitial lung disease reported in some patients. Monitoring includes blood counts and liver function, with dose adjustments for toxicity.