Metastatic breast cancer, an innovative drug increases survival
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Patients for whom an effective treatment cannot yet be found. Patients who have already received many therapies and therefore have developed resistance. For them it is necessary to develop alternatives, capable of lengthening survival without affecting the quality of life. One of these, certainly the most mature so far, is sacituzumab govitecan, as demonstrated by the data from the Tropics-02 study presented at the American Society of Clinical Oncology (Asco) Congress, currently underway in Chicago. “It is an antibody-drug conjugate, a drug which, thanks to its mechanism of action, manages to deposit the chemotherapy molecule directly inside the diseased cell, causing it to die. An innovation made available by scientific research that gives hope to these patients who must be taken care of by a multidisciplinary team, i.e. by breast centers, capable of intercepting and satisfying their need for global and lasting care”, explains Saverio Cinieri , president of the Italian Medical Oncology Association (Aiom).
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The results
The study compared sacituzumab govitecan and physician’s choice chemotherapy in patients with HR+/HER2- metastatic breast cancer, the most common type of breast cancer, who had already been treated with multiple drugs, endocrine therapies, and at least two chemotherapies. and for which it is therefore more difficult to find an effective drug. In this exploratory analysis, sacituzumab govitecan demonstrated a clinically meaningful lead improvement in median overall survival compared to the comparator arm, extending it by 3.3 months.
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“These longer-term results from the TROPiCS-02 study show the sustained overall survival advantage of sacituzumab govitecan over traditional chemotherapy in pre-treated HR+/HER2- metastatic breast cancer,” said Giuseppe Curigliano, professor of Medical Oncology at the University of Milan and Director of the Development Division of New Drugs for Innovative Therapies at the European Institute of Oncology in Milan -. At this stage of the disease, sequential chemotherapy is common, but benefits diminish with subsequent lines of therapy. The potential for a new molecule like sacituzumab govitecan, which can help patients live longer, is particularly significant.” In the study, median overall survival was 14.4 months with sacituzumab govitecan compared with 11.2 months with single agent chemotherapy.
Which is why the recently published European Society of Medical Oncology (ESMO) guidelines already include sacituzumab govitecan in the treatment algorithm in heavily pretreated hormone receptor positive metastatic disease. And Aiom is also preparing to rewrite the guidelines in the light of this and other important results obtained in recent months on the front of metastatic disease.
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The drug
Sacituzumab govitecan is an antibody-drug conjugate, i.e. a drug capable of recognizing the diseased cell, in this case targeting the Trop-2 receptor, hooking it and depositing a substance inside it, a topoisomerase I inhibitor, which damages the cell and affects on the surrounding microenvironment. Trop-2 is a target present on the cell surface of several types of cancer, including over 90% of breast and bladder cancers. To date, sacituzumab govitecan is approved in over 40 countries for the treatment of adult patients with unresectable locally advanced or metastatic triple-negative breast cancer (TNBC) who have received two or more prior systemic therapies, at least one of which was for metastatic disease. The presence of Trop-2 on the surface of different types of cancer cells is the reason why the same molecule is also being studied in the treatment of metastatic second-line urothelial carcinoma (UC), metastatic non-small cell lung cancer (NSCLC), metastatic small cell lung cancer (SCLC), head and neck cancer and endometrial cancer.
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