Trodelvy: What to Expect, Side Effects, and More

Trodelvy (chemical name: sacituzumab govitecan-hziy) is a targeted therapy medication called an antibody-drug conjugate (ADC) that targets a protein found on the surface of cancer cells. Once it attaches to these proteins and enters the cell, it releases chemotherapy, resulting in cell death.

You may be prescribed Trodelvy if:

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  You were diagnosed with triple-negative breast cancer that has spread to body parts away from the breast (metastatic) or can’t be removed with surgery and you’ve received two or more other treatments.

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  You were diagnosed with hormone receptor-positive, HER2-negative metastatic breast cancer or breast cancer that can’t be removed with surgery and you’ve received hormonal therapy and two or more other treatments.

See Trodelvy prescribing information.

Trodelvy is made up of two main parts linked together: a monoclonal antibody called sacituzumab and chemotherapy called SN-38. 

The antibody part helps track down cancer cells, which have higher amounts of the protein Trop-2 on their surface than other cells. The antibody then attaches to Trop-2. Once inside the cell, SN-38, a topoisomerase I inhibitor is released. This chemotherapy makes it hard for the cell to divide and grow.

SN-38 isn’t a targeted medicine, which means it can affect healthy cells as well as cancer cells. However, because SN-38 is linked to sacituzumab in Trodelvy, the medicine is able to target cancer cells with Trop-2 on them.  This makes Trodelvy less toxic to healthy cells and more effective in treating cancer cells.

Trodelvy is given intravenously, which means the medicine is delivered directly into your bloodstream through an IV or a port. Trodelvy is given once weekly on day one and day eight of a continuous 21-day treatment cycle unless the cancer grows or unacceptable side effects develop. 

Like almost all breast cancer medicines, Trodelvy can cause side effects, some of them severe.

The most common side effects of Trodelvy are:

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  low white blood cell counts

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  anemia

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  nausea

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  diarrhea

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  fatigue

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  vomiting

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  hair loss

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  constipation

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  abdominal pain

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  rash

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  decreased appetite

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  kidney problems

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  respiratory infection

Trodelvy also may cause serious side effects, including:

Severe neutropenia: Neutropenia means you have abnormally low levels of neutrophils, a type of white blood cell. People with neutropenia have a much higher risk of getting serious infections. Your doctor will monitor your neutrophil counts during treatment. If you develop neutropenia, you may be treated with a granulocyte-colony stimulating factor medicine such as Neupogen (chemical name: filgrastim), Neulasta (chemical name: pegfilgrastim), or Zarxio (chemical name: filgrastim-sndz). Some physicians prescribed these granulocyte-colony stimulating factors preventively, even if you have never developed neutropenia from Trodelvy. 

Severe diarrhea: Severe diarrhea can cause dehydration, low blood pressure, and severe kidney problems. Tell your doctor about any diarrhea you have so it can be treated right away.  

Hypersensitivity: Hypersensitivity is an immune response that can be severe and life-threatening, especially if anaphylaxis occurs. It typically occurs within 24 hours of treatment. 

You must use birth control while you're taking Trodelvy — and for at least six months after your last dose. Men who are taking Trodelvy should use effective birth control while taking Trodelvy, and for at least three months after their last dose.

Members of our community discuss their experiences with Trodelvy in the community forum. Here are some of their comments. Remember, it's essential to talk to your doctor about any side effects you're having and ask about ways to manage them.

“I'm finding Trodelvy to be a little tougher in terms of side effects than Enhertu, with the exception of nausea, which is better on Trodelvy.” —theresa45

“I have found Trodelvy to be very easy to tolerate. I did lose all of my hair but I started off with very little after letrozole and Abraxane treatments. Cold capping is unlikely to work for this kind of treatment. That being said, everyone's response is different, you may not lose your hair. From the first study, results [show that] 35% (38/108) got Alopecia. I had terrible mouth sores before taking Trodelvy and they have gotten better. Have more energy than I had on previous treatments.” —susaninsf

Read more in our Trodelvy discussion forum.

The cost of Trodelvy may vary. The price you’ll pay depends on the drug manufacturer, your health insurance provider and plan, where you live, and the pharmacy you use. 

Note: Your insurance company may require you to get prior authorization before covering Trodelvy.

Gilead also offers a savings program for Trodelvy.

Learn more about financial assistance and medicine cost-lowering tips.