[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antibody-drug conjugates (ADCs)](https://durgical.com/en/pharmacology/classes/antibody-drug-conjugates/) › Sacituzumab govitecan # Sacituzumab govitecan ## ADCs? Antibody-drug conjugates (ADCs) ## High alert? An error with this medicine can cause serious harm: double checks and protocols are used. ## Pregnancy: avoid? Avoid in pregnancy. Can harm the fetus; a pregnancy test is done and effective contraception is used during and after treatment, and breastfeeding is avoided. Anti-TROP-2 antibody carrying SN-38, the active form of irinotecan; used in advanced breast cancer. Boxed risks: severe neutropenia and diarrhoea. Updated Nov 1, 2026 ## Quick facts **Group** [Antibody-drug conjugates (ADCs)](https://durgical.com/en/pharmacology/classes/antibody-drug-conjugates/) **Target** TROP-2 (TACSTD2), a surface protein of many epithelial cancers **Used for** Unresectable **Key effects** Nausea · Fatigue · Hair loss **Monitor** Complete blood count before each dose **ATC** L01FX17 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ◆**TROP-2 (TACSTD2), a surface protein of many epithelial cancers**Sacituzumab govitecan ⓘ The crystal structure shows the TROP-2 extracellular region alone; the antibody and the SN-38 payload are not in it. **Target in 3D:** TROP-2 (TACSTD2), a surface protein of many epithelial cancers. PDB structure 7E5N (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7E5N) · Drag to rotate · pinch to zoom The humanised antibody binds TROP-2 on tumour cells and carries SN-38, the active metabolite of irinotecan, linked through hinge cysteines. Inside the tumour SN-38 is released and blocks topoisomerase I, so DNA breaks accumulate and the cell dies. - The antibody binds TROP-2 on the tumour cell - SN-38 is released in and around the tumour - SN-38 blocks topoisomerase I: DNA damage - Tumour cell death ## Indications - Unresectable or metastatic triple-negative breast cancer, and hormone receptor-positive, HER2-negative breast cancer, after several prior systemic therapies. [Breast cancer →](https://durgical.com/en/conditions/breast-cancer/) ## Adverse effects ### Common - Nausea, vomiting, diarrhoea, constipation - Fatigue - Hair loss - Anaemia - Decreased appetite ### Serious (rare, important) - Severe or fatal neutropenia and febrile neutropenia (boxed warning) - Severe diarrhoea with dehydration (boxed warning) - Infusion and allergic reactions - Higher toxicity in people with reduced UGT1A1 activity - Embryo-fetal toxicity ## Contraindications - Severe allergy to the drug ## Key interactions **UGT1A1 inhibitors** Raise SN-38 exposure and toxicity; avoided when possible. **UGT1A1 inducers** Lower SN-38 exposure. **Irinotecan** Shares the same active compound (SN-38): toxicities add up. ## What is monitored - Complete blood count before each dose - Bowel habit and hydration - Infusion reactions during and after each dose - UGT1A1 genotype when available or when toxicity is unexpected ## Administration and safety - Intravenous infusion only, never as a push; the patient is observed during and after each infusion. - Premedication against infusion reactions and nausea is given as ordered. - Hazardous drug: prepared and handled with chemotherapy precautions. ## Pregnancy and breastfeeding Avoid in pregnancy. Can harm the fetus; a pregnancy test is done and effective contraception is used during and after treatment, and breastfeeding is avoided. ## Nursing care - Check the neutrophil count before each dose and do not give it if the threshold set by the protocol is not met. - Ask about the number of stools; early diarrhoea is reported at once. - Watch for fever, chills or breathing difficulty during and after the infusion. - Teaching: report fever and diarrhoea immediately, keep drinking fluids, use effective contraception. ## Pharmacokinetics **Absorption** Intravenous infusion on set days of each cycle. **Metabolism** SN-38 is inactivated by glucuronidation through UGT1A1. ## Memory aid «Sacituzumab = irinotecan with a GPS»: SN-38 guided by TROP-2, so expect irinotecan's two problems: neutropenia and diarrhoea. ## Test yourself Think of the answer, then tap the question to see it. ## Which antigen does sacituzumab govitecan target? TROP-2, a surface protein of many epithelial cancers. ## Which well-known chemotherapy shares sacituzumab govitecan's payload? Irinotecan, whose active metabolite is SN-38. ## What are the two boxed warnings of sacituzumab govitecan? Severe neutropenia and severe diarrhoea. ## Why does UGT1A1 matter for sacituzumab govitecan? UGT1A1 inactivates SN-38; reduced activity raises the risk of neutropenia and diarrhoea. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/pharmacology/sacituzumab-govitecan/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **High alert** An error with this medicine can cause serious harm: double checks and protocols are used. **Pregnancy: avoid** Avoid in pregnancy. Can harm the fetus; a pregnancy test is done and effective contraception is used during and after treatment, and breastfeeding is avoided. ## Connections ## Related drugs 2 - [Irinotecan](https://durgical.com/en/pharmacology/irinotecan/) - [Trastuzumab deruxtecan](https://durgical.com/en/pharmacology/trastuzumab-deruxtecan/) ## Related conditions 1 - [Breast cancer](https://durgical.com/en/conditions/breast-cancer/) [← Back to the class: Antibody-drug conjugates (ADCs)](https://durgical.com/en/pharmacology/classes/antibody-drug-conjugates/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Sacituzumab govitecan-hziy Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a620034.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Sacituzumab Govitecan-hziy - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/sacituzumabgovitecan-hziy) (National Cancer Institute, 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01FX17) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/sacituzumab-govitecan/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/sacituzumab-govitecan/