Trodelvy (sacituzumab govitecan-hziy) is a prescription drug used to treat breast cancer in certain situations. Trodelvy comes as a powder that’s made into a liquid mixture. A healthcare professional injects it by intravenous (IV) infusion.
Trodelvy is prescribed to treat:
- unresectable, locally advanced, or metastatic triple-negative breast cancer in adults. For this use, Trodelvy is prescribed if you’ve received two or more systemic (whole body) treatments, including at least one treatment for metastatic breast cancer.
- unresectable, locally advanced, or metastatic hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer in adults who have received endocrine treatment and at least two systemic treatments for metastatic breast cancer
“Unresectable” means the cancer cannot be removed by surgery. “Locally advanced” means the cancer has spread beyond the breast to local tissue, such as nearby lymph nodes. “Metastatic” means the cancer has spread beyond the breast to other areas of the body, such as the bones or brain.
To learn more about Trodelvy’s indications, see the “What is Trodelvy used for?” section.
Trodelvy basics
Trodelvy contains the active ingredient sacituzumab govitecan-hziy.
Trodelvy is a biologic medication. A biologic is made from parts of living organisms. Trodelvy is available only as a brand-name drug. It isn’t available in a biosimilar form.
Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.
Biosimilars will have the same active ingredient core name as the brand-name drug. But they’ll have unique suffixes. This is why “-hziy” appears at the end of the name of the active ingredient. This is to show that it’s distinct from biosimilars that may be created in the future.
Trodelvy has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What should be considered before receiving Trodelvy?” section.
Trodelvy is prescribed to treat:
- unresectable, locally advanced, or metastatic triple-negative breast cancer in adults. For this use, Trodelvy is prescribed if you’ve received two or more systemic (whole body) treatments, including at least one treatment for metastatic breast cancer.
- unresectable, locally advanced, or metastatic hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer in adults who’ve received endocrine treatment and at least two systemic treatments for metastatic breast cancer
“Unresectable” means the cancer cannot be removed by surgery. “Locally advanced” means the cancer has spread beyond the breast to local tissue, such as nearby lymph nodes. “Metastatic” means the cancer has spread beyond the breast to other areas of the body, such as the bones or brain.
Symptoms of breast cancer include:
- a lump or mass on the breast
- changes in the feel, shape, or size of the breast
- changes in skin color, such as discoloration
- changes in the texture or appearance of one or both nipples
- swelling in lymph nodes around the collarbone or armpit
Trodelvy consists of an antibody (a type of immune system protein) connected to a chemotherapy drug. Both parts play a role in Trodelvy’s mechanism of action (how it works). The drug works to treat breast cancer by finding and attaching itself to a protein located on the surface of cancer cells. Once Trodelvy is attached to a cancer cell, the chemotherapy drug enters the cell. There it stops the cancer cell from growing and causes it to self-destruct.
Like most drugs, Trodelvy may cause mild to serious side effects. The lists here note the more common side effects of Trodelvy, but they don’t include all side effects possible.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Trodelvy. They also can suggest ways to help reduce side effects.
Mild side effects
The following list includes some of the mild side effects that Trodelvy can cause. To learn about other mild side effects, talk with your doctor or pharmacist or read Trodelvy’s prescribing information.
Mild side effects of Trodelvy that have been reported include:
- diarrhea
- mild nausea and vomiting
- fatigue (lack of energy)
- hair loss
- constipation
- abdominal pain
- mouth sores
- decreased appetite
- increased blood sugar level
- mild blood cell changes, including:
- mildly decreased hemoglobin
- mildly decreased platelet count
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Trodelvy can occur, but they aren’t common. If you have serious side effects from Trodelvy, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Trodelvy that have been reported include:
- severe nausea and vomiting
- blood cell changes, including:
- leukopenia (low white blood cell count)
- anemia (low red blood cell count)
- low level of electrolytes, including:
- hypokalemia (low blood potassium level)
- hypomagnesemia (low blood magnesium level)
- pneumonia
- infusion reactions during or within 24 hours after receiving a Trodelvy infusion, including:
- hypotension (low blood pressure)
- difficulty breathing
- boxed warnings: risks of severe neutropenia (low neutrophil count) and severe diarrhea (To learn more, see the “What should be considered before receiving Trodelvy?” section.)
ALLERGIC REACTIONFor some people, Trodelvy can cause an allergic reaction. In general, symptoms of allergic reaction can be mild or serious.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. They also can determine whether you should keep receiving Trodelvy.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911. Or call your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
Your doctor can confirm whether you’ve had a serious allergic reaction to Trodelvy. If they do, they may have you switch to a different treatment.
Here are commonly used dosages of Trodelvy. Your doctor will determine the dosage that’s right for you.
Form and strength
Trodelvy comes in one strength of 180 milligrams (mg). It’s available as a powder that a healthcare professional mixes into a liquid solution. They give you the drug by intravenous (IV) infusion (an injection into your vein over a period of time).
Recommended dosage
Your doctor will calculate your Trodelvy dosage using your body weight in kilograms (kg). For reference, 1 kg is about 2.2 pounds (lb).
The recommended Trodelvy dose for treating breast cancer is 10 mg per kg (also written “10 mg/kg”). Trodelvy dosages are on 21-day treatment cycles. This means you’ll receive a dose of Trodelvy on days 1 and 8 of each 21-day treatment cycle. You’ll likely continue receiving Trodelvy on this schedule as long as the medication is effective and doesn’t cause side effects that you can’t tolerate.
To learn more, see this Trodelvy dosage article.
How it’s given
Your doctor will explain how you’ll receive Trodelvy, including how much and how often.
Trodelvy powder is mixed into a liquid solution that you receive by IV infusion. This is an injection given into your vein over a period of time. You’ll receive infusions at your doctor’s office or a clinic. Your first Trodelvy infusion will likely take about 3 hours. After that, your other Trodelvy infusions will likely take 1 to 2 hours.
Before each Trodelvy infusion, it’s likely that your doctor will give you certain other medications. These will help prevent certain side effects from the infusion and may include a:
- medication, such as acetaminophen, to help prevent fever
- histamine blocker, such as diphenhydramine (Benadryl), to help prevent an allergic reaction
- corticosteroid, such as dexamethasone, to help prevent inflammation
- medication, such as aprepitant (Emend), to help prevent nausea and vomiting
After each Trodelvy infusion, your doctor will likely have you wait at the facility for at least 30 minutes. By doing so, they can observe you for any infusion reactions. And if you develop any, a healthcare professional will be available to treat them promptly.
Questions about receiving Trodelvy
Some common questions about receiving Trodelvy are:
- What if I miss a dose of Trodelvy? If you miss an appointment to receive a Trodelvy infusion, call your doctor’s office as soon as possible to reschedule.
- Will I need to use Trodelvy long term? Trodelvy treatment typically continues as long as it’s safe and effective for your condition. You’ll likely continue receiving Trodelvy until side effects develop that you can’t tolerate or the cancer worsens or spreads.
- How long does Trodelvy take to work? Trodelvy begins to work after you receive your first dose. But you likely won’t feel the drug working in your body. Your doctor will order tests throughout your treatment to check whether Trodelvy is working for your condition.
Consider the following important information before receiving Trodelvy.
Interactions
Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.
Before starting Trodelvy treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.
For more information, see this Trodelvy interactions article.
Drug interactions
Trodelvy can interact with several other medications, as noted in the following table. This table doesn’t include all drugs that may interact with Trodelvy.
| Drug group or drug name | Drug examples |
|---|---|
| certain antiepileptic drugs | • carbamazepine (Carbatrol, others) • phenytoin (Dilantin) |
| certain protease inhibitors | • efavirenz • atazanavir (Reyataz) |
| certain tyrosine kinase inhibitors | • nilotinib (Tasigna) • sorafenib (Nexavar) |
| oral ketoconazole | — |
| rifampin (Rimactane) | — |
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
Trodelvy and alcohol
Alcohol is not known to interact with Trodelvy. But consuming alcohol could worsen certain side effects of Trodelvy, such as nausea and vomiting. For this reason, talk with your doctor to determine whether it’s safe for you to consume alcohol during Trodelvy treatment.
Pregnancy and breastfeeding
Trodelvy is not safe to use during pregnancy or while breastfeeding.
Based on how the drug works, it could cause harm (including pregnancy loss) if used during pregnancy. If you can become pregnant, your doctor likely will order a pregnancy test to ensure you’re not pregnant before prescribing Trodelvy.
A child who’s breastfed by a person receiving Trodelvy has the potential for serious side effects. Due to this possibility, it’s recommended that you not breastfeed while receiving Trodelvy. It’s also recommended that you not breastfeed for at least 1 month after your last dose.
Birth control
It’s recommended that females who can become pregnant use birth control during treatment with Trodelvy. They also should use birth control for at least 6 months after receiving their last dose.
Males with partners who can become pregnant should use birth control during their treatment with Trodelvy. In addition, they should use birth control for at least 3 months after their last dose.
Note: In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. To learn more about this topic, see this article comparing sex and gender.
Boxed warnings
Trodelvy has boxed warnings about the risks of severe neutropenia (low neutrophil count) and severe diarrhea. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.
Risk of severe neutropenia: Treatment with Trodelvy can cause severe neutropenia (low neutrophil count), which can be life threatening. (Neutrophils are a type of white blood cell and a key part of your immune system.) A low neutrophil count can raise your risk of infection. This side effect can occur as early as the first Trodelvy treatment cycle.
Due to this risk, your doctor will check your neutrophil count regularly throughout your Trodelvy treatment. If your count is low and you develop a fever, they may pause your Trodelvy treatment or lower your Trodelvy dosage. They also may prescribe a medication such as Neulasta (pegfilgrastim). This medication can help increase neutrophils if you have a higher risk of neutropenia.
During your Trodelvy treatment, immediately notify your doctor if you have symptoms of an infection. These may include:
- fever
- cough
- chills
Risk of severe diarrhea: Severe diarrhea is a possible side effect reported with Trodelvy. This side effect can lead to dehydration, which may cause kidney problems such as sudden kidney injury. Diarrhea also may be a symptom of infection, which can be a sign of severe neutropenia. (See the warning just above.)
If you develop severe diarrhea, your doctor likely will prescribe an antidiarrheal medication such as loperamide. They also may prescribe fluid or electrolyte replacement if needed. It’s likely that your doctor will lower your Trodelvy dosage or pause your Trodelvy treatment until the diarrhea resolves.
Notify your doctor immediately if you have any of the following symptoms during treatment with Trodelvy:
- diarrhea
- black or bloody stools
- dehydration, which may cause lightheadedness or fainting
You can learn more about these boxed warnings by talking with your doctor.
Other warnings
Trodelvy can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors also may affect whether Trodelvy is a good treatment option for you.
Talk with your doctor about your health history before you start treatment with Trodelvy. Be sure to tell them if any of the following factors apply to you:
- you have the UGT1A1*28 gene
- liver problems, such as cirrhosis
- past allergic reaction to Trodelvy
- pregnancy
- breastfeeding
Is Trodelvy approved to treat metastatic urothelial cancer (MUC)?
No, Trodelvy is no longer approved to treat this type of cancer. In 2024, the manufacturer consulted with the FDA and withdrew its previous U.S. approval for treating locally advanced or MUC in certain people.
Trodelvy had received accelerated approval for locally advanced or MUC in 2021. With accelerated approval, the FDA grants a temporary permission that it may extend once the manufacturer provides further evidence about the drug. For Trodelvy, the manufacturer anticipated that the drug would provide a specific clinical benefit in further study. But the benefit was not achieved.
See the “What is Trodelvy used for?” section to learn about Trodelvy’s FDA-approved uses.
Is Trodelvy chemotherapy or immunotherapy?
Trodelvy is called an antibody-drug conjugate (ADC). It’s neither traditional chemotherapy nor immunotherapy. Instead, it consists of an antibody (a type of immune system protein) linked with a chemotherapy drug.
See the “What is Trodelvy used for?” section to learn more about how Trodelvy works.
How long does Trodelvy stay in your system?
Trodelvy can stay in your body for up to 5 days.
To calculate this, researchers determine the
Whether or not you have health insurance, cost may be a factor when you’re considering Trodelvy treatment. What you’ll pay for Trodelvy may depend on several things, such as your treatment plan. If you have questions about how to pay for your prescription, talk with your doctor.
You also can consider a savings program. A program called Gilead Oncology Support may be available, or check the Gilead Oncology Co-pay Program for additional information.
Other drugs are available that can treat your condition. If you’d like to explore an alternative to Trodelvy, talk with your doctor. They can tell you about other medications that might work for you.
The following drugs are similar to Trodelvy:
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.