[Use of sacituzumab govitecan in HR+/HER2- metastatic breast cancer following progression on endocrine therapy and chemotherapy: a case report in line with the results of the TROPiCS-02 study.]

Abstract

Metastatic hormone receptor-positive HR+/HER2- breast cancer represents the most common biological subtype of advanced breast cancer. Despite the significant improvements achieved with the introduction of CDK4/6 inhibitors combined with endocrine therapy, disease progression eventually occurs in a substantial proportion of patients, requiring additional therapeutic strategies. In this context, antibody-drug conjugates have emerged as one of the most relevant therapeutic innovations in recent years. We report the case of a 60-year-old woman with metastatic HR+/HER2- breast cancer with liver, nodal and bone involvement at diagnosis. The patient initially received first-line endocrine therapy with letrozole combined with abemaciclib, achieving disease control for approximately 18 months before radiological progression. She subsequently underwent chemotherapy with paclitaxel plus bevacizumab, followed by capecitabina with further progression of liver and bone metastases. Based on her treatment history and current evidence, chemotherapy with sacituzumab govitecan was initiated. Treatment is currently ongoing with radiological disease stability lasting about 10 months and good tolerability. This clinical case reflects the efficacy and manageable safety profile observed in the TROPiCS-02 trial and highlights the growing role of antibody-drug conjugates in the treatment sequence of metastatic HR+/HER2- breast cancer.