Sacituzumab Govitecan

How it works

A monoclonal antibody directed against Trop-2, expressed on many epithelial tumours, is linked to SN-38, the active metabolite of irinotecan and a topoisomerase I inhibitor, delivering the cytotoxic payload to tumour cells where it causes DNA damage and cell death.

Prescribing in practice

• It carries a major risk of severe, potentially life-threatening neutropenia and severe diarrhoea, requiring prompt management and treatment modification.
• It must only be prescribed and administered by clinicians experienced in cytotoxic chemotherapy, with facilities to manage infusion reactions and myelosuppression.
• Patients deficient in UGT1A1 are at increased risk of severe neutropenia and adverse effects and require careful assessment.

Monitoring

Monitor full blood count regularly before and during treatment and assess for neutropenia, diarrhoea and infusion-related reactions, adjusting therapy accordingly.

Counselling the patient

• Report fever, sore throat or other signs of infection immediately as these may signal a low white cell count.
• Seek urgent advice for severe or persistent diarrhoea so it can be treated promptly.
• Effective contraception is required, as the drug can harm a developing baby.

Evidence & guidelines

Use is governed by marketing authorisation and NICE/regulatory appraisal for specific oncology indications; follow the SPC and specialist protocols.