Safety and Efficacy of Sacituzumab Govitecan

EP: 1.Initial Diagnosis of Triple-Negative Breast Cancer

EP: 2.Neoadjuvant Chemotherapy for TNBC

EP: 3.Surgical Options for Triple-Negative Breast Cancer

EP: 4.Active Surveillance for Disease Progression in TNBC

EP: 5.Considerations for Referral After Progression of TNBC

EP: 6.The ASCENT 3 Trial of Sacituzumab Govitecan for TNBC

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EP: 7.Safety and Efficacy of Sacituzumab Govitecan

EP: 8.Social Support Systems for Patients With TNBC

EP: 9.Advice for Future Patients and Caregivers in TNBC

Aditya Bardia, M.D., MPH: The ASCENT trial demonstrated a doubling of overall survival with Trodelvy [sacituzumab govitecan] compared to standard chemotherapy. It looks like you made the right choice by participating in the trial. Clearly this is an agent that has activity in that setting. It does have some side effects. It can cause diarrhea, can lower the [white blood cell] counts, and unfortunately, it tends to cause hair loss as well. How has your experience been with Trodelvy in terms of side effects?

Latasha Jordan: The diarrhea is my biggest side effect. I was already used to the whole hair loss issue. My hair had just grown back. Do you remember me saying, “I just got my hair done?”

Aditya Bardia, M.D., MPH: I remember having that discussion. Yes.

Latasha Jordan: I got over it quickly. I knew that I didn’t look so bad with a bald head, so I was fine.

I still get joint pain, but not as bad as I did the first time. I get nausea, but it isn’t too severe. It’s the diarrhea, hands down. My biggest side effect is the diarrhea.

Aditya Bardia, M.D., MPH: That is something that tends to be seen with Trodelvy, in part because of the chemotherapy portion. The antibody is linked to chemotherapy, called SN-38, and that tends to cause diarrhea. It looks like that’s what you’re experiencing as well.

In terms of efficacy, you’re still on the same treatment, now for more than a year, year and a half.

Latasha Jordan: Yes. It’s working for me. It seems like every time I get a scan, it’s better. It gets better. I remember I couldn’t even take two steps without being out of breath. I could barely have a conversation. It was bad. Look at me now. It’s a blessing, I’m telling you.

Aditya Bardia, M.D., MPH: From a scan perspective, we’ve seen what we would call a response, which means that the tumor is shrinking. Usually, in the setting of breast cancer, as long as the disease does not grow, we consider it a success. We know that if a treatment is ineffective or if there is no treatment, the cancer would grow at a certain rate. If you apply a treatment and you can halt the progression, that’s a good sign. What’s even better than that is if you can shrink the tumor. That’s what we’re seeing in Latasha’s case. With this treatment, the tumors have decreased more than 50% from what they were before starting on this treatment. It emphasizes how successful this has been.

Coming back to what I was saying earlier, participating in the clinical trial not only helped Latasha, but it’s helping the next generation of patients as well. From a research perspective, we are doing research to determine, like in Latasha’s case, if there are certain markers that can predict this nice response to treatment. So when we consider future patients, if they have the same marker or the same signature, we can use this treatment. That would also help us refine the use of these agents moving forward.

Latasha Jordan: From where I was when I first met you up to now, it’s a blessing and a curse. I was so overweight, and I had high blood pressure. I was a prediabetic. As bad as hearing that I had triple-negative breast cancer was, all of these other great things have happened. I’m not a prediabetic patient anymore. I no longer have high blood pressure. This medication has helped me in different areas. I’m not mad. I still go to work, I just don’t work full time anymore. I work two days and I’m OK with that. Certain things in my life have changed. I’m living. That’s what I care about the most. I’m here for my son, my family. I thank God for you and for your team. God blessed me with two great teams: Boston Medical Center and Massachusetts General Hospital. My life is great.

Aditya Bardia, M.D., MPH: You’ve done very well. You bring up weight loss and how that helped with blood pressure control as well as prediabetes control. It was an indirect effect of the treatment because of side effects, but probably a positive one in your case. And, you’re able to work. We always talk about quality of life. Our goal in treatment is prolongation of survival and improving or maintaining quality of life. It looks like your quality of life is maintained if you’re able to work.

Tell us about your work. How was work before? And now that you’ve been working part time, tell us about your work and the adjustments you’ve had to make. Overall, do you feel satisfied with your work?

Latasha Jordan: Yes, I’m totally satisfied. I’m not upset. I can still work. That’s the whole point. When a situation comes your way, you still want to be able to remain who you were before this so-called block, this hurdle that you have to step over. I’m stepping over this hurdle. It’s not going to bring me down. It’s going to make me want to work that much harder. Do I get tired? Yes, I do. I get tired faster than I would have before, but it’s not going to stop me from going to work. I’m still going to go to work. I still basically do the same things I was doing before, just fewer hours.

Aditya Bardia, M.D., MPH: You clearly have a positive attitude. I think that’s helped as well. I’m very glad that you’re able to work. You brought up a very important point, which we sometimes tend to discuss in clinic, which is living with cancer or living with metastatic breast cancer. You’ve emphasized this a couple of times. It’s the ability to live and to enjoy things that are important to you. That’s a very important goal. Not just in terms of tumor reductions and responses on scans, but in terms of symptoms and how you’re feeling.

In terms of other patients on this drug, as you highlighted the common side effects tend to be diarrhea, hair loss, as well as drops in [blood cell] counts. Usually, this all requires medication. The efficacy of cold caps is unclear in this setting. There is ongoing research to see if cold caps could help with hair loss.

Transcript edited for clarity.