Sacituzumab govitecan improved health-related quality of life in patients with previously treated metastatic breast cancer, with the benefit observed in multiple clinically relevant subgroups, according to research presented at the 2024 San Antonio Breast Cancer Symposium.

TROPiCS-02 and EVER-132-002, both randomized phase 3 trials, compared sacituzumab govitecan with treatment of physician’s choice in previously treated patients with HR-positive, HER2-negative metastatic breast cancer.

The researchers evaluated health-related quality of life in the overall population of the trials, as well as in several subgroups. These included patients with previous exposure to CDK4/6 inhibitors — a requirement in TROPiCS-02 but not in EVER-132-002 — and patients with rapid progression, which the researchers defined as prior CDK4/6 duration less than 12 months.

“A statistically significant increase in time to first clinically meaningful deterioration was observed with sacituzumab govitecan compared to treatment of physician’s choice for 6 of 15 domains of the EORTC QLQ-C30, including Global Health Status/Quality of Life, physical functioning, emotional functioning, fatigue, pain, and dyspnea measures, in the overall and prior CDK4/6 inhibitor population.”

-Hope S. Rugo, MD, director of breast oncology and clinical trials education, UCSF Helen Diller Family Comprehensive Cancer Center, and colleagues wrote

Sacituzumab govitecan was numerically favored in four domains (role functioning, cognitive functioning, social functioning, and insomnia), while three domains numerically favored treatment of physician’s choice (appetite loss, constipation, and financial difficulty). In addition, two domains significantly favored treatment of physician’s choice (nausea/vomiting and diarrhea).

Similar results were seen in the subgroup of patients with rapid progression for the six domains that favored sacituzumab govitecan, as well as in the domain of financial difficulty. A sensitivity analysis revealed consistent findings for the overall and CDK4/6-exposed populations, with a loss of statistical significance for pain and gain for financial difficulty.

“Sacituzumab govitecan demonstrated statistically longer time to first clinically meaningful deterioration over treatment of physician’s choice for EQ-5D-5L Visual Analog Scale, with and without considering death as an event for all three patient subgroups (hazard ratios ranging from 0.63 to 0.76; P < .001),” Rugo and colleagues continued. “The consistency of these results across different patient populations and several time-to-event analyses enhances the generalizability of the individual trials and reinforced the health-related quality of life benefits associated with sacituzumab govitecan versus treatment of physician’s choice.”

Reference:
https://sabcs.org/Portals/0/Documents/Formatted_Abstracts%2011-27%20Without%20Embargoed.pdf?ver=qjVzk5LPNjOteEIvNEYJFw%3d%3d

Disclosures: The TROPiCS-02 and EVER-132-002 clinical trials were both supported by Gilead Sciences.

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