Trodelvy Infusion Schedule
Trodelvy (sacituzumab govitecan) is administered intravenously at 10 mg/kg on Days 1 and 8 of a 21-day treatment cycle, meaning each infusion is run over approximately 1-3 hours depending on whether it is the first or subsequent dose. 1
Standard Dosing Schedule
- Dose: 10 mg/kg intravenously 1
- Schedule: Days 1 and 8 of each 21-day cycle 2, 1
- Continue: Until disease progression or unacceptable toxicity 1
Infusion Duration
- First infusion: Approximately 3 hours (includes premedication time of ~30 minutes, then infusion over ~3 hours) 1
- Subsequent infusions: Can be shortened to approximately 1-2 hours if the first infusion is well-tolerated 1
- Premedication required: Antiemetics and other supportive medications should be given before each infusion 1
Treatment Duration in Clinical Practice
- Median treatment duration: 4.1 months (range: 0 to 63 months) across all tumor types 1
- In metastatic triple-negative breast cancer: Median duration was 4.4 months (range: 0 to 23 months) 1
- Treatment continues: Until disease progression or unacceptable toxicity occurs 1
Critical Monitoring Points
Do not stop Trodelvy between scheduled doses unless toxicity requires dose modification. 1 The most common reasons for treatment interruption (occurring in 63% of patients) include neutropenia (47%), diarrhea (5%), respiratory infection (5%), and leukopenia (5%). 1
Dose Modifications
- Treatment interruptions: Occurred in 63% of patients, most frequently for neutropenia 1
- Dose reductions: Required in 22% of patients, primarily for neutropenia (11%) and diarrhea (5%) 1
- Permanent discontinuation: Necessary in only 5% of patients 1
Special Considerations for UGT1A1 Genotype
Patients homozygous for UGT1A1*28 allele experience earlier and more severe toxicity, with median time to first neutropenia of 9 days (versus 15 days for heterozygotes and 20 days for wild-type). 1 These patients require closer monitoring and may need earlier dose modifications. 1