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Topic: Sacituzumab Govitecan (Trodelvy)

Forum: Triple-Negative Breast Cancer — Share with others who have ER-/PR-/HER2- breast cancer.

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Posted on: May 21, 2020 12:30PM

Posted on: May 21, 2020 12:30PM

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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Mar 10, 2021 08:32PM 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-, 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-, 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 01:19PM 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 12:31PM 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 12:52PM 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- Surgery 12/12/2017 Lumpectomy; Lumpectomy (Left); Lymph node removal Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole breast: Breast Dx 2/2020, IDC, Left, 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) Radiation Therapy 12/9/2020 External Hormonal Therapy 12/16/2020 Femara (letrozole) Radiation Therapy 3/3/2021 External Local Metastases 3/3/2021 Radiation therapy: Bone Targeted Therapy 1/1/2022 Trodelvy (sacituzumab govitecan-hziy) Chemotherapy 6/1/2022 Other
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Mar 27, 2021 01:14AM 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 08:20AM 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 08:34AM anornurse wrote:

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

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Mar 30, 2021 12:46AM 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 12:49PM 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 6/2/2017 AC + T (Taxol) Surgery 11/28/2017 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/5/2017 Surgery 1/2/2018 Radiation Therapy 3/5/2018 Whole breast: Breast, Lymph nodes Surgery 9/1/2018 Reconstruction (right) Surgery 9/27/2018 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 2/8/2019 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 10:10PM 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- Chemotherapy 4/15/2008 AC + T (Taxol) Targeted Therapy 5/30/2013 Ibrance (palbociclib) Hormonal Therapy 9/1/2014 Faslodex (fulvestrant) 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- Chemotherapy 12/10/2020 Doxil (doxorubicin) Hormonal Therapy Femara (letrozole) Chemotherapy Gemzar (gemcitabine)

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