Medicine: sacituzumab govitecan (brand name: Trodelvy®)

The Scottish Medicines Consortium (SMC) has accepted sacituzumab govitecan as a treatment for breast cancer in adults. It is used when the person has already had 2 or more treatments, where at least 1 of these was for advanced cancer. It is only used if the cancer:

• Cannot be removed by surgery (is unresectable),
• Is triple negative, which means it does not have receptors for oestrogen and progesterone, and tests negative for a protein called HER2, and
• Has spread to nearby tissue or lymph nodes (is locally advanced). Or has spread to other parts of the body (is metastatic).

You can find more detailed information about the SMC assessment of sacituzumab govitecan by looking at the SMC Detailed Advice Document (SMC2446).

SMC’s decision takes into account a confidential discount offered by the pharmaceutical company. SMC was also able to be more flexible* in its decision-making because the medicine is for:

• A rare condition, and
• A condition where patients taking current treatments are likely to live less than 3 years.

Sacituzumab govitecan is an antibody (sacituzumab) linked to an anti-cancer drug (SN-38), that targets cells with Trop-2 proteins on their surface. Trop-2 is expressed at high levels on the surface of TNBC cells. By targeting Trop-2 the antibody enables direct delivery of SN-38 to tumour cells. Once inside the tumour cells, SN-38 prevents them from being able to repair damaged DNA, this prevents them from multiplying and they eventually die.

*https://www.scottishmedicines.org.uk/how-we-decide/pace/

SMC carefully considers every new medicine to make sure it benefits patients and is considered to be an acceptable use of the limited resources in NHSScotland. To do this SMC considers the following:

• Evidence from the company about how well the medicine works compared with current treatments available in Scotland, in relation to how much they will cost to buy and administer.
• Information from patient groups about the potential impact of the medicine on patients and carers.
• Advice from healthcare professionals about any benefits of the new medicine compared to current treatment, along with how the new medicine is likely to be used.

When SMC assesses a medicine it takes account of the needs of all patients in NHSScotland, not only those who may be treated with the medicine under consideration. You can find more detailed information about the SMC assessment of sacituzumab govitecan by looking at the SMC Detailed Advice Document (SMC2446).

The organisations below can provide more information and support for people with breast cancer and their families. SMC is not responsible for the content of any information provided by external organisations.

Breast Cancer Now

https://breastcancernow.org0800 822 3370

METUPUK

https://metupuk.org.uk

You can find out more about sacituzumab govitecan (Trodelvy®) in the Patient Information Leaflet (PIL) by searching for the medicine name on the Medicines and Healthcare products Regulatory Agency (MHRA) website.

https://products.mhra.gov.uk/