sacituzumab govitecan
Sacituzumab govitecan (Trodelvy) is an antibody-drug conjugate that targets Trop-2, a protein found on many cancer cells. It delivers a cancer-killing drug directly into those cells. It is used to treat certain types of breast cancer, including triple-negative and hormone receptor-positive breast cancers.
This page is based on EMA and FDA prescribing information for sacituzumab govitecan injection, cross-checked with DailyMed; the mechanism is explained in plain language, and analogies are used only where they stay accurate.
How it works
Explains what the medicine does in the body, not dosing, side effects, or safety.
An analogy
Sacituzumab govitecan works like a trojan horse. The antibody part recognizes Trop-2, a protein found on the surface of many breast cancer cells. Once it attaches, the cancer cell pulls the whole molecule inside. Then a powerful cancer-killing drug is released, destroying the cell from within. Nearby cancer cells may also be affected because the drug can leak out and reach them too.
In simple terms
Sacituzumab govitecan is made of two parts: an antibody that finds cancer cells, and a cancer-killing drug attached to it. The antibody binds to a protein called Trop-2, which is found in large amounts on the surface of many breast cancer cells. Once attached, the whole molecule is pulled inside the cancer cell, where the cancer-killing drug is released and destroys the cell. The drug can also affect nearby cancer cells. It is used to treat certain types of breast cancer, including triple-negative breast cancer and hormone receptor-positive breast cancer, often after other treatments have stopped working.
In depth
Sacituzumab govitecan is an antibody-drug conjugate (ADC) consisting of a humanized monoclonal antibody directed against Trop-2 (TACSTD2), conjugated to SN-38 (the active metabolite of irinotecan), a topoisomerase I inhibitor. Trop-2 is overexpressed in a wide range of epithelial tumors, including breast cancer. Upon binding to cell-surface Trop-2, the ADC is internalized, and SN-38 is released by hydrolysis of the cleavable linker. SN-38 inhibits topoisomerase I, causing DNA double-strand breaks and apoptosis. The conjugate exhibits bystander effects due to membrane permeability of SN-38, enabling killing of neighboring antigen-low or antigen-negative cells. Sacituzumab govitecan is approved for metastatic triple-negative breast cancer and HR-positive, HER2-negative breast cancer after prior endocrine therapy and systemic chemotherapy.
See it in motion
A schematic animation of the mechanism — simplified for clarity, not drawn to scale.
Sacituzumab govitecan works like a trojan horse.
- Sacituzumab govitecan is made of two parts: an antibody that finds cancer cells, and a cancer-killing drug attached to it.
- The antibody binds to a protein called Trop-2, which is found in large amounts on the surface of many breast cancer cells.
- Once attached, the whole molecule is pulled inside the cancer cell, where the cancer-killing drug is released and destroys the cell.
- The drug can also affect nearby cancer cells.
Target: Trop-2 (Trophoblast cell-surface antigen 2)
A transmembrane glycoprotein overexpressed on many epithelial cancers, including breast cancer; serves as the binding target for sacituzumab govitecan, enabling selective delivery of the cytotoxic payload to tumor cells.
Approved uses
Approved uses differ by country and change over time. Always follow your local prescribing information.
Approved uses in European Union
EMA- Trodelvy as monotherapy is indicated for the treatment of adult patients with unresectable or metastatic hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer who have received endocrine-based therapy and at least two additional systemic therapies in the advanced setting
- Trodelvy as monotherapy is indicated for the treatment of adult patients with unresectable or metastatic triple-negative breast cancer (TNBC) who have received two or more prior systemic therapies, at least one of them for advanced disease
Approved uses in United States
FDA- TRODELVY is indicated for the first-line treatment of adult patients with unresectable locally advanced or metastatic triple negative breast cancer (TNBC) who are not candidates for PD-1 or PD-L1 inhibitor-based therapy
- TRODELVY, in combination with pembrolizumab, is indicated for the first-line treatment of adult patients with unresectable locally advanced or metastatic TNBC whose tumors express PD-L1 (CPS ≥ 10) as determined by an FDA-authorized test
- TRODELVY is indicated for the treatment of adult patients with unresectable locally advanced or metastatic TNBC who have received two or more prior systemic therapies, at least one of them for metastatic disease
- TRODELVY is indicated for the treatment of adult patients with unresectable locally advanced or metastatic hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer who have received endocrine-based therapy and at least two additional systemic therapies in the metastatic setting
Approved uses in United States
DailyMed- TRODELVY is indicated for the first-line treatment of adult patients with unresectable locally advanced or metastatic triple negative breast cancer (TNBC) who are not candidates for PD-1 or PD-L1 inhibitor based therapy
- TRODELVY, in combination with pembrolizumab, is indicated for the first-line treatment of adult patients with unresectable locally advanced or metastatic TNBC whose tumors express PD-L1 (CPS ≥ 10) as determined by an FDA-authorized test
- TRODELVY is indicated for the treatment of adult patients with unresectable locally advanced or metastatic TNBC who have received two or more prior systemic therapies, at least one of them for metastatic disease
- TRODELVY is indicated for the treatment of adult patients with unresectable locally advanced or metastatic hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer who have received endocrine-based therapy and at least two additional systemic therapies in the metastatic setting
Official sources
The statements on this page trace back to these records.
- U.S. Food and Drug Administration: sacituzumab govitecan prescribing information
U.S. Food and Drug Administration
- DailyMed: sacituzumab govitecan labeling
DailyMed, U.S. National Library of Medicine
This page explains how the medicine works — it isn’t the patient leaflet. For anything that applies to you, read the leaflet that came with your medicine or ask your pharmacist.
MedUnfold provides educational content and is not medical advice. Always follow your local prescribing information and healthcare professional.