Abstract P1-06-12: Efficacy and safety of the addition of prophylactic atropine to patients with metastatic triple-negative breast cancer treated with sacituzumab govitecan: a Spanish multicenter real-world study
Abstract
Background: Sacituzumab govitecan (SG) is a first-in-class trophoblastic antigen-2 (Trop-2)-directed antibody‒drug conjugate (ADC) composed of a humanized monoclonal antibody (hRS7 IgG1κ) that recognizes Trop-2 and SN-38, a topoisomerase I inhibitor which is covalently attached to the antibody by a hydrolysable linker and results in DNA damage leading to apoptosis and cell death. SG showed a significant and clinically meaningful improvement in progression-free survival (PFS) and overall survival (OS) compared with single-agent chemotherapy among patients with pretreated advanced triple negative (TN) and luminal HER2 negative breast cancer (BC) in the ASCENT1 and TROPiCS-022 trials, respectively. SN-38 can cause early-onset diarrhea through parasympathetic stimulation and delayed diarrhea via intestinal epithelial damage, inflammation, and dysbiosis. In clinical trials, the safety profile of SG was manageable, with febrile neutropenia (4.8%), diarrhea (3.9%), neutropenia (2.6%) and pneumonia (2%) being the most frequently reported serious adverse reactions3, causing dose reductions and treatment discontinuations. Atropine is a muscarinic acetylcholine receptor antagonist that suppresses the parasympathetic effects of SN-38. Premedication with atropine sulfate in treatments such as SG could improve the management of severe diarrhea associated with cholinergic syndrome. Objective: To evaluate the efficacy and safety of the use of prophylactic atropine to prevent diarrhea in…
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