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Topic: Sacituzumab Govitecan (Trodelvy)

Forum: Triple-Negative Breast Cancer —

Share with others who have ER-/PR-/HER2- breast cancer.

Posted on: May 21, 2020 09:30AM

Erich wrote:

Hello everyone. I was wondering if anyone(s) could share any experiences they have had using sacituzumab govitecan (Trodelvy) either in a clinical trial or as recently approved by the FDA.

We are trying to determine if it's the best plan of action for my wife at this time. There are 2 key things we are trying to determine.


1) How bad are the side effects (I've read everything from "terrible" to "manageable")?

2) Has it helped with your brain metastases or other CNS metastases? This is a tough question, I know. There is next to zero clinical data on it so far. Just trying to get any anecdotal evidence I can at this point.


Thank you all for any information on this! :)



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Jan 28, 2021 07:58AM DoubleBloom wrote:

It's nice to hear from you, Libby. Good to know that nothing is growing... now I pray for you that things start shrinking. Glad to know your side effects are in control. It must give you at least some relief.

Dx 5/11/2017, IDC, Left, 3cm, Stage IIIA, Grade 3, 0/7 nodes, ER-/PR-, HER2- Chemotherapy 6/1/2017 AC + T (Taxol) Surgery 11/27/2017 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/4/2017 Surgery 1/1/2018 Radiation Therapy 3/5/2018 Whole-breast: Breast, Lymph nodes Surgery 8/31/2018 Reconstruction (right) Surgery 9/26/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Dx 1/31/2019, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2- Radiation Therapy 2/7/2019 External: Brain Surgery 3/21/2019 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Dx 10/16/2019, IDC, 3cm, Stage IV, metastasized to other, Grade 3, 0/7 nodes, ER-/PR-, HER2- Dx 8/28/2020, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2-
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Jan 28, 2021 08:28AM anornurse wrote:

Libby, It's great to hear from you! Enjoy your next 3 months, you certainly derserve it! I grew up with a wonderful Mom and Dad who believed the glass was always half full. It must have rubbed off on me, lol! I have good news I would like to share and it's not about tnbc. Our daughter and son-in-law are going to have a baby in August! I'm going to be a Grandmom! Life is very special and it's nice to share with everyone! Sharon (anornurse)

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Jan 28, 2021 08:35AM DoubleBloom wrote:

HUGE CONGRATULATIONS Sharon!! That is something beyond special to look forward to. I'm very happy for you.

Dx 5/11/2017, IDC, Left, 3cm, Stage IIIA, Grade 3, 0/7 nodes, ER-/PR-, HER2- Chemotherapy 6/1/2017 AC + T (Taxol) Surgery 11/27/2017 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/4/2017 Surgery 1/1/2018 Radiation Therapy 3/5/2018 Whole-breast: Breast, Lymph nodes Surgery 8/31/2018 Reconstruction (right) Surgery 9/26/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Dx 1/31/2019, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2- Radiation Therapy 2/7/2019 External: Brain Surgery 3/21/2019 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Dx 10/16/2019, IDC, 3cm, Stage IV, metastasized to other, Grade 3, 0/7 nodes, ER-/PR-, HER2- Dx 8/28/2020, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2-
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Feb 13, 2021 12:28PM texaslaughter wrote:

Just popping in to say I started my 10th cycle yesterday. I continue to be blessed with a great response. Labs all normal, with tumor markers within the normal range indicating little to no cancer activity. Last scan on 12/30 shows significant changes and reductions, I have my next scan in a couple of weeks. This is the longest that any treatment has worked for me since I became metastatic. I've been back to work fulltime for over 3 months in a high paced role, working at home during COVID, and been able to manage it fine. Being at home allows me to take naps when I need them. :) Glad to see many more have been able to gain the benefits from this drug. It's not the easiest, especially in the beginning, but it works. It really does. All the best.

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Feb 13, 2021 09:26PM - edited Feb 13, 2021 09:27PM by NorCalS

Texaslaughter,

Thanks for checking in and sharing your good news. It's very helpful to know that Trodelvy is effective.

Anornurse, congrats to you and your family. Great news

Dx 6/17/2019, IDC, Left, 6cm+, Stage IIIC, Grade 3, ER-/PR-, HER2- Chemotherapy 6/24/2019 AC + T (Taxol) Chemotherapy 4/6/2020 Xeloda (capecitabine) Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Feb 16, 2021 01:02PM sac321 wrote:

Is Trodelvy specific for Triple Negative or also can be used for er+/pr+/her-?

I don't have triple-negative; mine is strong ER+ with Her2-. Today, my MO decided to go with Trodelvy after she felt Xeloda is not working anymore. Your input is greatly appreciated

Dx 3/2018, ILC, Left, 6cm+, Stage IIIB, Grade 3, ER+/PR+, HER2- Dx 8/2020, Stage IV, metastasized to liver, ER+/PR-, HER2- Chemotherapy Halaven (eribulin) Chemotherapy Xeloda (capecitabine)
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Feb 16, 2021 01:12PM - edited Feb 16, 2021 01:14PM by moth

sac321, I've only seen it recommended for TNBC. My copy NCCN guidelines lists it for tnbc. Keytruda (another immunotherapy) recently got FDA approval for ER+ tumors with high tumor mutation burden &/or microsatellite instability (established by genomic tests such as Foundation One) but I've not seen trodelvy recommended for that. Maybe I missed something ... hope someone else wades in with evidence for this

ETA: link to FDA running updates on approved cancer treatments. Trodelvy is only listed for TNBC in April 2020. So I think this would be offlabel use?

https://www.fda.gov/drugs/resources-information-ap...


I take weekends off

Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the Odds

Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/19/2020 Tecentriq (atezolizumab) Chemotherapy 11/26/2020 Abraxane (albumin-bound or nab-paclitaxel) Dx 12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, PR-, HER2- (IHC) Radiation Therapy 12/9/2020 External: Chest wall Dx 1/28/2021, IDC, Left, Stage IV, metastasized to bone Radiation Therapy 3/3/2021 External: Bone
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Feb 16, 2021 08:56PM sac321 wrote:

Thanks, moth. I noticed the same thing as you did, which is why I am asking here. I saw that "SusaninSF" had this treatment possibly because of her low Her2 (from the info below), but not sure.

Topic: Are you currently (or have you have been) in a Clinical Trial? (page 53)

Dx 3/2018, ILC, Left, 6cm+, Stage IIIB, Grade 3, ER+/PR+, HER2- Dx 8/2020, Stage IV, metastasized to liver, ER+/PR-, HER2- Chemotherapy Halaven (eribulin) Chemotherapy Xeloda (capecitabine)
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Mar 10, 2021 10:54AM Wanderingneedle wrote:

Unfortunately I may be moving off of Trodelvy. ☹️ My skin mets have returned - they are small bumps under my arm. I will have a scan in two weeks but in the meantime we’re returning my dosage to full strength for this cycle to see if it makes a difference since the skin mets almost completely disappeared after just the first cycle. After 3 cycles at full strength it was reduced because of side effects and that’s when the cancer stopped shrinking and stayed the same size. I just had a scan in January and showed nothing was growing or shrinking so I guess the cancer is pushing back now. My doctor ordered the blood test for circulating tumor cells dna and she has my last biopsy results and she clinical trials beginning soon and she researched TNBC. Almost all of her patients are metastatic. I’m in good hands. As much as I don’t like the side effects I’d like to get some more time out of this treatment before moving on because none of them seem to last long.

I hope everyone else is doing well! Spring is coming and so much to look forward to! 🌸🌼🌷🌱

Libby - Just trying to figure it all out and keep up with daily life. Dx 11/9/2017, IDC, Right, 6cm+, Stage IV, metastasized to bone, Grade 3, ER+/PR+, HER2- (IHC) Targeted Therapy 1/23/2018 Ibrance (palbociclib) Hormonal Therapy 1/23/2018 Femara (letrozole) Chemotherapy 9/14/2018 Abraxane (albumin-bound or nab-paclitaxel) Hormonal Therapy 2/11/2019 Faslodex (fulvestrant) Chemotherapy 2/12/2019 Doxil (doxorubicin) Chemotherapy 2/27/2019 Halaven (eribulin) Dx 11/6/2019, IDC, Right, Stage IV, Grade 3, ER-/PR-, HER2- (IHC) Chemotherapy 12/4/2019 Abraxane (albumin-bound or nab-paclitaxel) Immunotherapy 12/5/2019 Tecentriq (atezolizumab) Chemotherapy 3/17/2020 Ixempra (ixabepilone) Chemotherapy 3/17/2020 Xeloda (capecitabine) Chemotherapy 5/11/2020 Xeloda (capecitabine) Targeted Therapy 8/31/2020 Trodelvy (sacituzumab govitecan-hziy) Radiation Therapy 4/20/2021 External: Bone Chemotherapy 8/20/2021 Carboplatin (Paraplatin), Gemzar (gemcitabine)
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Mar 10, 2021 11:06AM moth wrote:

Wanderingneedle, oh I'm sorry to hear about the skin mets returning. Any chance they can be whackamoled through surgical excision or radiation? My team seems currently gung ho on treating anything that crops up as an oligoprogression (currently with rads) to delay moving off treatment. Do you have other mets which are responding at all?

I take weekends off

Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the Odds

Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/19/2020 Tecentriq (atezolizumab) Chemotherapy 11/26/2020 Abraxane (albumin-bound or nab-paclitaxel) Dx 12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, PR-, HER2- (IHC) Radiation Therapy 12/9/2020 External: Chest wall Dx 1/28/2021, IDC, Left, Stage IV, metastasized to bone Radiation Therapy 3/3/2021 External: Bone
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Mar 10, 2021 06:32PM Wanderingneedle wrote:

Thanks, moth,

She didn’t mention radiation or surgery. I had radiation there last year and these showed up about halfway through and I thought it was possibly from the radiation. Because of COVID my oncologist at the time was only doing online appointments even after he knew about the new skin mets (he never saw me). He offered me gemzar as a single agent and went to a second opinion about that treatment and I stayed. My current oncologist is looking for mutations and the scan will tell us if everything else is also growing. My first two oncologists would not be so proactive - just throw something else out there and see if it works.I asked to go back to the full dose to see if it would work because I hate to just give up. I’m so heavily pretreated now I hate to get rid of anything that’s working. It’s just the side effects that are hard.

Libby - Just trying to figure it all out and keep up with daily life. Dx 11/9/2017, IDC, Right, 6cm+, Stage IV, metastasized to bone, Grade 3, ER+/PR+, HER2- (IHC) Targeted Therapy 1/23/2018 Ibrance (palbociclib) Hormonal Therapy 1/23/2018 Femara (letrozole) Chemotherapy 9/14/2018 Abraxane (albumin-bound or nab-paclitaxel) Hormonal Therapy 2/11/2019 Faslodex (fulvestrant) Chemotherapy 2/12/2019 Doxil (doxorubicin) Chemotherapy 2/27/2019 Halaven (eribulin) Dx 11/6/2019, IDC, Right, Stage IV, Grade 3, ER-/PR-, HER2- (IHC) Chemotherapy 12/4/2019 Abraxane (albumin-bound or nab-paclitaxel) Immunotherapy 12/5/2019 Tecentriq (atezolizumab) Chemotherapy 3/17/2020 Ixempra (ixabepilone) Chemotherapy 3/17/2020 Xeloda (capecitabine) Chemotherapy 5/11/2020 Xeloda (capecitabine) Targeted Therapy 8/31/2020 Trodelvy (sacituzumab govitecan-hziy) Radiation Therapy 4/20/2021 External: Bone Chemotherapy 8/20/2021 Carboplatin (Paraplatin), Gemzar (gemcitabine)
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Mar 25, 2021 10:19AM thrivingmama wrote:

Hi everyone. I am curious - has anyone been on a lower dose (like 50%), had progression, and then had success with increasing the dose?

TIA

Jan '18: Diagnosed Stage IV w/ 2 liver mets. NED April-Oct. Stopped chemo. Jan '19: new liver mets + spread to bones. Restarted GemCarbo + Xgeva. Worked well for 6 months, then progressed. Currently on Eribulin, which is holding me stable Dx 12/2016, IDC: Tubular/IBC, Left, Stage IIIC, Grade 2, ER+/PR+, HER2- Chemotherapy 1/11/2017 AC + T (Taxol) Surgery 6/11/2017 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left; Reconstruction (left): DIEP flap Hormonal Therapy 7/15/2017 Faslodex (fulvestrant) Radiation Therapy 7/18/2017 Whole-breast: Breast, Lymph nodes, Chest wall Targeted Therapy 9/14/2017 Ibrance (palbociclib) Hormonal Therapy 9/14/2017 Dx 1/2018, Stage IV, metastasized to liver, Grade 3, ER-/PR-, HER2- Chemotherapy 2/8/2018 Carboplatin (Paraplatin), Gemzar (gemcitabine) Dx 1/2019, IDC: Tubular, Stage IV, metastasized to bone/liver Chemotherapy Carboplatin (Paraplatin), Gemzar (gemcitabine)
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Mar 26, 2021 09:31AM thrivingmama wrote:

Hi. I am adding a bit more detail to my question, in case anyone has thoughts :). I also posted on the liver mets and enhertu threads.

I am wondering if anyone has been on Trodelvy at a lower dose and then increased it with success? Also, does anyone have experience with both Trodelvy and Enhertu?

I was on Trodelvy June 2020-Jan 2021. I was on a 50% dose the entire time, and I had a really spectacular response, but unfortunately had progression in January. We debated going up in dose, but decided instead to try Abraxane. While I had one of the larger liver tumors respond to Abraxane, the rest have increased in size and activity, so I need to move on. I am again thinking about going back to Trodelvy, but at a higher dose. I am also looking into access to Enhertu. So, curious if anyone has any experience or words of wisdom.

I am heavily pre-treated and the Phase I trial world seems quiet right now....

Thanks for any thoughts :)

Jan '18: Diagnosed Stage IV w/ 2 liver mets. NED April-Oct. Stopped chemo. Jan '19: new liver mets + spread to bones. Restarted GemCarbo + Xgeva. Worked well for 6 months, then progressed. Currently on Eribulin, which is holding me stable Dx 12/2016, IDC: Tubular/IBC, Left, Stage IIIC, Grade 2, ER+/PR+, HER2- Chemotherapy 1/11/2017 AC + T (Taxol) Surgery 6/11/2017 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left; Reconstruction (left): DIEP flap Hormonal Therapy 7/15/2017 Faslodex (fulvestrant) Radiation Therapy 7/18/2017 Whole-breast: Breast, Lymph nodes, Chest wall Targeted Therapy 9/14/2017 Ibrance (palbociclib) Hormonal Therapy 9/14/2017 Dx 1/2018, Stage IV, metastasized to liver, Grade 3, ER-/PR-, HER2- Chemotherapy 2/8/2018 Carboplatin (Paraplatin), Gemzar (gemcitabine) Dx 1/2019, IDC: Tubular, Stage IV, metastasized to bone/liver Chemotherapy Carboplatin (Paraplatin), Gemzar (gemcitabine)
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Mar 26, 2021 09:52AM moth wrote:

Are you on Twitter because Dr Rebecca Shatsky is very familiar with Trodelvy, is doing research on it, and she interacts with pts and responds to questions a lot. https://twitter.com/Dr_RShatsky/status/13752389821...


I take weekends off

Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the Odds

Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/19/2020 Tecentriq (atezolizumab) Chemotherapy 11/26/2020 Abraxane (albumin-bound or nab-paclitaxel) Dx 12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, PR-, HER2- (IHC) Radiation Therapy 12/9/2020 External: Chest wall Dx 1/28/2021, IDC, Left, Stage IV, metastasized to bone Radiation Therapy 3/3/2021 External: Bone
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Mar 26, 2021 10:14PM thrivingmama wrote:

Thank you for the tip! I've actually seen Dr. Shatsky and could probably reach out to her through myChart too. I'll check out her twitter. Thanks!

Jan '18: Diagnosed Stage IV w/ 2 liver mets. NED April-Oct. Stopped chemo. Jan '19: new liver mets + spread to bones. Restarted GemCarbo + Xgeva. Worked well for 6 months, then progressed. Currently on Eribulin, which is holding me stable Dx 12/2016, IDC: Tubular/IBC, Left, Stage IIIC, Grade 2, ER+/PR+, HER2- Chemotherapy 1/11/2017 AC + T (Taxol) Surgery 6/11/2017 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left; Reconstruction (left): DIEP flap Hormonal Therapy 7/15/2017 Faslodex (fulvestrant) Radiation Therapy 7/18/2017 Whole-breast: Breast, Lymph nodes, Chest wall Targeted Therapy 9/14/2017 Ibrance (palbociclib) Hormonal Therapy 9/14/2017 Dx 1/2018, Stage IV, metastasized to liver, Grade 3, ER-/PR-, HER2- Chemotherapy 2/8/2018 Carboplatin (Paraplatin), Gemzar (gemcitabine) Dx 1/2019, IDC: Tubular, Stage IV, metastasized to bone/liver Chemotherapy Carboplatin (Paraplatin), Gemzar (gemcitabine)
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Mar 29, 2021 05:20AM texaslaughter wrote:

stopping by for a scan update. Just had my 3rd scan with trodelvy and on cycle 12?. I had too numerous to count liver tumors and 2 large at 13 cms. The smaller ones can’t be seen and the 2 are now grape sized and walnut sized at 3/4 cms. The side effects get so much easier but I continue to have a great response. My doc wants us to get another 6 months from this but it has literally been my life saver. God and modern medicine has been good to me.

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Mar 29, 2021 05:34AM anornurse wrote:

Texaslaughter, Way to go! We are all rooting for you! Sharon

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Mar 29, 2021 09:46PM thrivingmama wrote:

Texas - excellent news! thanks for sharing

Jan '18: Diagnosed Stage IV w/ 2 liver mets. NED April-Oct. Stopped chemo. Jan '19: new liver mets + spread to bones. Restarted GemCarbo + Xgeva. Worked well for 6 months, then progressed. Currently on Eribulin, which is holding me stable Dx 12/2016, IDC: Tubular/IBC, Left, Stage IIIC, Grade 2, ER+/PR+, HER2- Chemotherapy 1/11/2017 AC + T (Taxol) Surgery 6/11/2017 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left; Reconstruction (left): DIEP flap Hormonal Therapy 7/15/2017 Faslodex (fulvestrant) Radiation Therapy 7/18/2017 Whole-breast: Breast, Lymph nodes, Chest wall Targeted Therapy 9/14/2017 Ibrance (palbociclib) Hormonal Therapy 9/14/2017 Dx 1/2018, Stage IV, metastasized to liver, Grade 3, ER-/PR-, HER2- Chemotherapy 2/8/2018 Carboplatin (Paraplatin), Gemzar (gemcitabine) Dx 1/2019, IDC: Tubular, Stage IV, metastasized to bone/liver Chemotherapy Carboplatin (Paraplatin), Gemzar (gemcitabine)
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Apr 13, 2021 09:49AM DoubleBloom wrote:

I was on Trodelvy from Sept to Dec 2020. My treatment was every other week and I also had intrathecal topotecan every month.

In Dec, my brain and spine were clear of any tumors so my doctor said I could come off all the chemo and take a break from all the side effects. Unfortunately my most recent MRIs in March showed three new tumors in the brain. I had gamma knife radiation last week and will go back on Trodelvy starting this Friday.

How long have some of you been on Trodelvy without a break and what are your worst side effects.

Thanks in advance.

Dx 5/11/2017, IDC, Left, 3cm, Stage IIIA, Grade 3, 0/7 nodes, ER-/PR-, HER2- Chemotherapy 6/1/2017 AC + T (Taxol) Surgery 11/27/2017 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/4/2017 Surgery 1/1/2018 Radiation Therapy 3/5/2018 Whole-breast: Breast, Lymph nodes Surgery 8/31/2018 Reconstruction (right) Surgery 9/26/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Dx 1/31/2019, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2- Radiation Therapy 2/7/2019 External: Brain Surgery 3/21/2019 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Dx 10/16/2019, IDC, 3cm, Stage IV, metastasized to other, Grade 3, 0/7 nodes, ER-/PR-, HER2- Dx 8/28/2020, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2-
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Apr 13, 2021 07:10PM S3K5 wrote:

I am new to this forum but not new to breastcancer.org; I have been a member since 2008. It is good to read about all the positive stories regarding Trodelvy. If I get the insurance approval, I may be soon starting this drug,

In 2008 I was initially diagnosed as ER+/PR+/Her2-ve but in Oct2020, my MO repeated the biopsy and genomic profile. It showed that the tumor cells had mutated to Triple negative. I had metastases in my spine only since 2013 but 5 years later it showed up in the liver. I have been through many treatments (12+) but none of them for longer than 4-6 months either due to side effects or due to progression. I had to stop the previous two treatments due to severe skin reaction and feet swelling. I have extremely sensitive skin.

Is there anything I need to know about Trodelvy other than the listed side effects? I will ask my MO for prescription strength anti-diarrhea and anti-nausea medicines. Would it be a good idea to ask for a prescription for a steroid? Is anyone taking steroids to mitigate the side effects?

All tips and advise about how to deal with the side effects are welcome. I am running out of options for the treatments and I need this drug to WORK. My liver and spine have diffuse metastatic lesions. I hope this turns out to be a miracle drug for me, just like it did for others on this forum.

Keeping my fingers crossed for the insurance approval.

S3K5 Dx 3/24/2008, IDC, Right, 3cm, Stage IIIA, Grade 2, 5/10 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 4/15/2008 AC + T (Taxol) Targeted Therapy 5/30/2013 Ibrance (palbociclib) Chemotherapy 2/1/2019 Xeloda (capecitabine) Chemotherapy 4/5/2019 Taxol (paclitaxel) Chemotherapy 10/30/2019 CMF Targeted Therapy 7/7/2020 Piqray (alpelisib) Dx 10/19/2020, IDC, Right, Stage IV, metastasized to bone/liver, ER-/PR-, HER2- (IHC) Chemotherapy 12/10/2020 Doxil (doxorubicin) Hormonal Therapy Faslodex (fulvestrant) Hormonal Therapy Femara (letrozole) Chemotherapy Gemzar (gemcitabine)
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Apr 14, 2021 01:45AM anornurse wrote:

Hello, I have been on trodelvy since 5/20. when it first came out. I am taking a break from 3/21 til present. I have tnbc, brain, spine and both lungs. I received the cyber knife for both lungs which is working well. I believe in trodelvy very much. Please read Gilead Science's press release from 7/7/21. It has received full FDA approval. I think you will believe as well. Sharon

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Apr 14, 2021 01:50AM anornurse wrote:

I am off trodelvy now, since 3/21. I received the cyber knife to both lungs and it is working well. My diarrhea was manageable with over the counter meds. My white cell count was normal. My hemoglobin went down to 8.8. Please read Gilead Science's press release from7/7/21. Trodelvy has full FDA approval. The press release is very encouraging! Sharon

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Apr 14, 2021 05:59AM DoubleBloom wrote:

S3K5... It's nice to have you in the group. I didn't need steroids while on Trodelvy though the nurses gave me one pill as a part of my premeds. I did develop a severe rash and became neutropenic which required a 5 day hospital stay. After that I took Zarxio injections to keep my blood counts up. I had a week of constipation followed by a week of diarrhea. Fatigue was always an issue.

Anornurse... Thanks to mentioning Gilead's press release. Congrats for getting off the Trodelvy. Your good response is encouraging.

Dx 5/11/2017, IDC, Left, 3cm, Stage IIIA, Grade 3, 0/7 nodes, ER-/PR-, HER2- Chemotherapy 6/1/2017 AC + T (Taxol) Surgery 11/27/2017 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/4/2017 Surgery 1/1/2018 Radiation Therapy 3/5/2018 Whole-breast: Breast, Lymph nodes Surgery 8/31/2018 Reconstruction (right) Surgery 9/26/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Dx 1/31/2019, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2- Radiation Therapy 2/7/2019 External: Brain Surgery 3/21/2019 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Dx 10/16/2019, IDC, 3cm, Stage IV, metastasized to other, Grade 3, 0/7 nodes, ER-/PR-, HER2- Dx 8/28/2020, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2-
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Apr 14, 2021 02:38PM S3K5 wrote:

DoubleBloom and anornurse thanks for your response.

It is awesome to hear positive stories about this drug. Yes, I have been reading and following everything about this drug since I knew this was probably on my list.

Sharon, are you on any other treatment or is your MO planning to monitor you with scans?

DoubleBloom when you were on Trodelvy, what did you do for your skin rashes? Did you take any steroid for that or did the rash resolve by itself? When did you develop the rashes? Thanks for letting me know about neutropenia. I'll ask my MO to give me Neulasta or Nupogen to prevent this. My MO had ordered Dexamethasone IV (steroid) and Aloxi (anti-nausea medicine) as premeds with other chemo regimens (Taxol). Hopefully she may put in an order for these again with Trodelvy.

S3K5 Dx 3/24/2008, IDC, Right, 3cm, Stage IIIA, Grade 2, 5/10 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 4/15/2008 AC + T (Taxol) Targeted Therapy 5/30/2013 Ibrance (palbociclib) Chemotherapy 2/1/2019 Xeloda (capecitabine) Chemotherapy 4/5/2019 Taxol (paclitaxel) Chemotherapy 10/30/2019 CMF Targeted Therapy 7/7/2020 Piqray (alpelisib) Dx 10/19/2020, IDC, Right, Stage IV, metastasized to bone/liver, ER-/PR-, HER2- (IHC) Chemotherapy 12/10/2020 Doxil (doxorubicin) Hormonal Therapy Faslodex (fulvestrant) Hormonal Therapy Femara (letrozole) Chemotherapy Gemzar (gemcitabine)
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Apr 15, 2021 11:05AM DoubleBloom wrote:

S3K5...I was on Trodelvy for four months from last Sept to Dec. Tough side effects plus negative scans made my MO advise a break from all chemo. I think he was very surprised to see the tumors come back so quickly. The skin rash only happened once, after my 2nd infusion, and I was admitted to the hospital. Because my WBC was only 0.04 I could not be put on steroids at that time since steroids can increase the risk of serious infection. I was placed on all sorts of antibiotics and discharged when my blood counts improved. I only receive dexamethasone as one of my premeds on the day of infusion. I start back on Trodelvy and intrathecal topotecan tomorrow. My doc doesn't think the rash will recur.

Let me know if you have any other questions.

Dx 5/11/2017, IDC, Left, 3cm, Stage IIIA, Grade 3, 0/7 nodes, ER-/PR-, HER2- Chemotherapy 6/1/2017 AC + T (Taxol) Surgery 11/27/2017 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/4/2017 Surgery 1/1/2018 Radiation Therapy 3/5/2018 Whole-breast: Breast, Lymph nodes Surgery 8/31/2018 Reconstruction (right) Surgery 9/26/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Dx 1/31/2019, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2- Radiation Therapy 2/7/2019 External: Brain Surgery 3/21/2019 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Dx 10/16/2019, IDC, 3cm, Stage IV, metastasized to other, Grade 3, 0/7 nodes, ER-/PR-, HER2- Dx 8/28/2020, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2-
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Apr 15, 2021 11:18AM Wanderingneedle wrote:

S3K5,

these are my premeds - Tylenol, Zyrtec (or Benadryl), dexamethasone, famotidine, fasoprepitant, heparin, and aloxi. These are given to everyone on this regimen at my cancer center. I started at 100%, then reduced because of side effects but I had some progression so back to 100%.

If you are on Facebook there is a group for Trodelvy. Some people tolerate this treatment very well, others have all the bad side effects. My worst has been fatigue and diarrhea/constipation issues. Diet helps some with the gut issues but the medicines are necessary for me. In the beginning I had 2 blood transfusions for the fatigue (reduction of red blood cells/hemoglobin/hematocrit) and the dose reduction helped with that.

I will be getting radiation for the new spot on my pelvis and continue with this for now. I don’t have a heavy tumor burden but nothing works for very long. I hope it works well for you!



Libby - Just trying to figure it all out and keep up with daily life. Dx 11/9/2017, IDC, Right, 6cm+, Stage IV, metastasized to bone, Grade 3, ER+/PR+, HER2- (IHC) Targeted Therapy 1/23/2018 Ibrance (palbociclib) Hormonal Therapy 1/23/2018 Femara (letrozole) Chemotherapy 9/14/2018 Abraxane (albumin-bound or nab-paclitaxel) Hormonal Therapy 2/11/2019 Faslodex (fulvestrant) Chemotherapy 2/12/2019 Doxil (doxorubicin) Chemotherapy 2/27/2019 Halaven (eribulin) Dx 11/6/2019, IDC, Right, Stage IV, Grade 3, ER-/PR-, HER2- (IHC) Chemotherapy 12/4/2019 Abraxane (albumin-bound or nab-paclitaxel) Immunotherapy 12/5/2019 Tecentriq (atezolizumab) Chemotherapy 3/17/2020 Ixempra (ixabepilone) Chemotherapy 3/17/2020 Xeloda (capecitabine) Chemotherapy 5/11/2020 Xeloda (capecitabine) Targeted Therapy 8/31/2020 Trodelvy (sacituzumab govitecan-hziy) Radiation Therapy 4/20/2021 External: Bone Chemotherapy 8/20/2021 Carboplatin (Paraplatin), Gemzar (gemcitabine)
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Apr 15, 2021 11:30AM anornurse wrote:

I received cyber knife to my brain and both lungs and get monitored by a cat scan of my chest and an MRI of my brain. I have been off the trodelvy since 3/21. That’s my story and I’m sticking to it, lol! Sharon

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Apr 17, 2021 06:40AM DoubleBloom wrote:

Wanderingneedle... Sorry to hear that you required blood transfusion and now radiation. I wish you immense luck with that and tolerating Trodelvy. I've had abdominal pain and my onco prescribed hycosamine for it. It's a sublingual tablet that does help. I also use miracle mouthwash for burning in my esophagus. I can't tolerate anything spicy or too acidic. I found I was eating a lot of bland carbs and packed on 15 pounds which is a nightmare to lose when I have so much fatigue.

Anornurse... I pray that you have a nice long remission!

Dx 5/11/2017, IDC, Left, 3cm, Stage IIIA, Grade 3, 0/7 nodes, ER-/PR-, HER2- Chemotherapy 6/1/2017 AC + T (Taxol) Surgery 11/27/2017 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/4/2017 Surgery 1/1/2018 Radiation Therapy 3/5/2018 Whole-breast: Breast, Lymph nodes Surgery 8/31/2018 Reconstruction (right) Surgery 9/26/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Dx 1/31/2019, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2- Radiation Therapy 2/7/2019 External: Brain Surgery 3/21/2019 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Dx 10/16/2019, IDC, 3cm, Stage IV, metastasized to other, Grade 3, 0/7 nodes, ER-/PR-, HER2- Dx 8/28/2020, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2-
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Apr 20, 2021 05:33PM Grannax2 wrote:

I’m new to this thread. Just trying to educate myself in case I need Trodelvy in the near future. I have a long, complicated history of BC and MBC. Yes, I’m heavily pre treated, etc. My MO said after so many different chemos, Ibecome resistant and my odds are low for my cancer to respond

At this point, I have diffuse liver mets and very few choices left for chemo. I’ve been on BCO since 2017. I’ve exhausted all options for local TX to liver. I also have lung mets. It’s a long story.

I’m on Navelbine right now. I just started it after Eribulin failed. I post mostly on the liver mets thread.

So, I’m curious to hear about your experiences on Trodelvy. 💞

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Apr 21, 2021 06:36AM DoubleBloom wrote:

Hello Grannax2... Welcome to the grouup though Ii wish you didn't have to be here. I've been battling MBC since 2017 like you however my mets are just in my brain and spine. Trodelvy is a very promising drug and if you get started on it I hope you have a positive outcome as several us have experienced. You can read back to some of the previous posts to see what the side effects are like.

Also, read Glilead's Press Release as anornurse suggested. (I hope the link works)

Dx 5/11/2017, IDC, Left, 3cm, Stage IIIA, Grade 3, 0/7 nodes, ER-/PR-, HER2- Chemotherapy 6/1/2017 AC + T (Taxol) Surgery 11/27/2017 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/4/2017 Surgery 1/1/2018 Radiation Therapy 3/5/2018 Whole-breast: Breast, Lymph nodes Surgery 8/31/2018 Reconstruction (right) Surgery 9/26/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Dx 1/31/2019, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2- Radiation Therapy 2/7/2019 External: Brain Surgery 3/21/2019 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Dx 10/16/2019, IDC, 3cm, Stage IV, metastasized to other, Grade 3, 0/7 nodes, ER-/PR-, HER2- Dx 8/28/2020, IDC, 3cm, Stage IV, metastasized to brain, Grade 3, 0/7 nodes, ER-/PR-, HER2-

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