Indications for TRODELVY:
Treatment of adults with metastatic triple-negative breast cancer (mTNBC) who have received at least 2 prior therapies for metastatic disease.
Premedicate with antipyretics, H1 and H2 blockers prior to infusion; may use corticosteroids for those with prior infusion reactions. Also, can premedicate with a 2 or 3 drug combination regimen (eg, dexamethasone with either a 5-HT3 or NK1 receptor antagonist, others). Give by IV infusion over 3hrs for 1st infusion, then over 1–2hrs for subsequent infusions if tolerated. 10mg/kg (max dose) once weekly on Days 1 and 8 of 21-day cycles. Continue until disease progression or unacceptable toxicity. Dose modifications for adverse reactions: see full labeling.
Do not substitute Trodelvy for or use with other drugs containing irinotecan or its active metabolite SN-38. Risk for severe neutropenia. Withhold therapy if ANC <1500/mm3 on Day 1 of any cycle, neutrophil count <1000/mm3 on Day 8 of any cycle, or neutropenic fever occurs. Monitor CBCs periodically during treatment. Consider G-CSF for secondary prophylaxis. Initiate anti-infective treatment without delay if febrile neutropenia occurs. Risk for severe diarrhea (monitor and evaluate for infectious causes if occurs), nausea, vomiting. Withhold dose for Grade 3/4 diarrhea, Grade 3 nausea, Grade 3/4 vomiting; resume when resolved to Grade ≤1; give loperamide, additional antiemetics, and other supportive measures as clinically indicated. Monitor closely for infusion-related reactions during and for at least 30mins after each infusion. Permanently discontinue if life-threatening infusion-related reactions occur. Patients homozygous for UGT1A1*28 allele. Monitor closely in those with reduced UGT1A1 activity for severe neutropenia. Moderate to severe hepatic impairment. Embryo-fetal toxicity. Advise to use effective contraception during and for 6 months (females) or 3 months (males w. female partners) after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 1 month after the last dose).
Trop-2 directed antibody and topoisomerase inhibitor conjugate.
May be potentiated by UGT1A1 inhibitors; avoid. May be antagonized by UGT1A1 inducers; avoid.
Nausea, neutropenia, diarrhea, fatigue, anemia, vomiting, alopecia, constipation, rash, decreased appetite, abdominal pain; lab abnormalities, hypersensitivity reactions.
Half-life: 16hrs (sacituzumab govitecan-hziy) and 18hrs (free SN-38).