International Breast Cancer Center (IBCC), Pangaea Oncology, Quiron Hospital, Barcelona, Spain.
Medica Scientia Innovation Research (MEDSIR), Oncoclínicas & Co, Sao Paulo, NJ, USA.
Expert Rev Anticancer Ther. 2024 Oct;24(10):949-958. doi: 10.1080/14737140.2024.2392775. Epub 2024 Aug 29.
Initial treatment for hormone-receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer (ABC) typically involves endocrine therapy (ET) combined with different targeted agents. When hormonal therapies fail, until recently, the only option available was chemotherapy (ChT), presenting a significant therapeutic challenge. However, the recent introduction of antibody-drug conjugates (ADCs) has provided new treatment alternatives in this context. Sacituzumab govitecan (SG), a novel trophoblast cell-surface antigen 2 (Trop-2)-targeting ADC, has been evaluated following disease progression to ET and ChT in HR+/HER2- ABC.
This review examines the latest clinical trials, including phase I/II and III studies and evaluates the impact of SG on HR+/HER2- ABC. The literature search focused on clinical outcomes, particularly regarding efficacy and safety, comparing them with traditional ChT.
SG has demonstrated to be an effective treatment for patients with HR+/HER2- ABC after progression to ET and cyclin-dependent kinase 4/6 inhibitors (CDKi) in any setting, and at least two ChT-containing regimens in the advanced setting. With a manageable toxicity profile, SG represents a significant advancement in the treatment landscape for this patient population. However, further research is essential to optimize its application and establish long-term benefits.
激素受体阳性(HR+)/人表皮生长因子受体 2 阴性(HER2-)晚期乳腺癌(ABC)的初始治疗通常涉及内分泌治疗(ET)联合不同的靶向药物。当激素治疗失败时,直到最近,唯一可用的选择是化疗(ChT),这带来了重大的治疗挑战。然而,最近抗体药物偶联物(ADC)的引入为这一领域提供了新的治疗选择。Sacituzumab govitecan(SG)是一种新型滋养细胞表面抗原 2(Trop-2)靶向 ADC,在 HR+/HER2-ABC 中,在 ET 和 ChT 进展后进行了评估。
本综述考察了最新的临床试验,包括 I/II 期和 III 期研究,并评估了 SG 对 HR+/HER2-ABC 的影响。文献检索侧重于临床结果,特别是疗效和安全性,并将其与传统 ChT 进行比较。
SG 已被证明是 HR+/HER2-ABC 患者在任何情况下进展至 ET 和细胞周期蛋白依赖性激酶 4/6 抑制剂(CDKi)后以及在晚期至少两种含 ChT 方案后的有效治疗方法。SG 具有可管理的毒性特征,代表了该患者群体治疗领域的重大进展。然而,仍需要进一步研究来优化其应用并确定长期获益。