Sacituzumab govitecan makes case as third-line therapy in mTNBC

Third-line treatment with sacituzumab govitecan works better than the physician’s treatment of choice in metastatic triple-negative breast cancer (mTNBC), an invasive histologic subtype with a poor prognosis and rapid progression, as shown in a recent study.

“Currently, there is no standard therapy for the third-line treatment of mTNBC,” the investigators said. “In this study, we conducted a network meta-analysis to compare regimens and determine treatment outcomes.”

A systematic search was conducted using the databases of PubMed, Embase, and the Cochrane Central Register of Controlled Trials, as well as the minutes of major conferences.

The investigators used the R software (R Core Team) and performed a network meta-analysis to analyse clinical outcomes, such as progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). They then compared the efficacy of treatment regimens using hazard ratios (HRs), odds ratios (ORs), and 95 percent confidence intervals (CIs).

Fifteen randomized controlled trials, including a total of 6,010 patients, were included in the meta-analysis. Sacituzumab govitecan, compared with the physician’s choice treatment, significantly improved PFS (HR, 0.41, 95 percent CI, 0.32‒0.52) and OS (HR, 0.48, 95 percent CI, 0.39‒0.60). Sacituzumab govitecan also outclassed other therapies in terms of ORR (OR, 10.82, 95 percent CI, 5.58‒20.97).

In safety analyses, the incidence of grades 3 to 5 adverse reactions such as neutropenia and leukopenia was higher in each regimen, but that of fever, headache, hypertension, and rash was fewer.