SABCS 2025: Clarifying Where Sacituzumab Govitecan Fits in the Breast Cancer Treatment Landscape

Erika Hamilton, MD, FASCO Sarah Cannon Research Institute | Dionisia Quiroga, DO, PhD The Ohio State University

December 25, 2025

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Key Points

  • Frontline sacituzumab govitecan demonstrated improved outcomes in triple-negative breast cancer (TNBC), including in combination with pembrolizumab for PD-L1–positive disease.

  • Toxicity management and dosing remain key considerations for clinical adoption.

  • In the ASCENT-07 study, sacituzumab did not demonstrate a strong progression-free survival (PFS) benefit in hormone receptor (HR)–positive, HER2-negative disease.

New data presented at the 2025 San Antonio Breast Cancer Symposium reinforced sacituzumab govitecan as a major player in TNBC. The antibody-drug conjugate (ADC) showed improved outcomes in first-line settings, both combined with pembrolizumab for PD-L1–positive cases and with chemotherapy alone.

At the conference, Erika Hamilton, MD, of Sarah Cannon Research Institute, and Dionisia Quiroga, DO, PhD, of The Ohio State University, discussed the ADC’s promise despite the regiment not yet receiving FDA approval.

For TNBC, confirming PD-L1 status and triple-negative disease is essential, Dr. Hamilton said, adding that she believes this treatment approach will be routinely adopted into practice.

However, she emphasized the need for careful management. Sacituzumab govitecan is given on days 1 and 8 of a 21-day cycle, with neutropenia and diarrhea as notable side effects. Growth factor support, including pegylated formulations, is often used to maintain dosing schedules, while logistical factors such as clinic access and patient convenience are also important considerations.

The clinicians also offered insight on sacituzumab govitecan’s role in HR-positive, HER2-negative disease. Data from the ASCENT-07 trial revealed that compared with chemotherapy, sacituzumab did not demonstrate a strong PFS benefit, with only modest trends in overall survival.

Overall, although ADCs remain highly effective in TNBC, their role in first-line HR-positive disease is limited, highlighting the need for ongoing research and careful patient selection.