If you or someone you know has breast cancer, learning about new treatments can be both hopeful and filled with questions. Today, we’re going to talk about one such new hope, a drug called Trodelvy. It’s a treatment for two specific types of breast cancer (Triple-negative breast cancer - TNBC and HR+/HER2- breast cancer) that have spread too far to be removed by surgery or that have not responded to two other treatments. Let’s talk about this simply and in a friendly way.
How does Trodelvy work inside the body?
Simply put, Trodelvy is a "targeted therapy." This means that instead of just going around the body, this drug goes directly to find and attack cancer cells.
Think of this as a missile heading straight for the target.
1. Detecting cancer cells: Many breast cancer cells have a protein called Trop-2 on their surface. The drug Trodelvy contains a special part (monoclonal antibody) that can attach to this Trop-2 protein. This is what specifically identifies the cancer cell.
2. Administering the drug: After attaching to the cancer cell, Trodelvy releases a powerful chemical drug (a chemotherapy drug called SN-38) hidden inside the cancer cell.
3. Destroying cancer cells: Once inside the cancer cell, this SN-38 drug stops the cell from dividing and making more cells (copying its DNA). Then the cancer cell cannot grow any further and dies.
The biggest advantage of this method is that it targets and attacks only cancer cells, minimizing damage to healthy cells.
How is this treatment given?
Trodelvy is a medicine that is given as a saline solution into a vein (IV Infusion) . You will receive this in a hospital or cancer treatment center, under the supervision of a doctor or trained nursing staff.
The treatment is given in a 21-day cycle. That is, the medicine is given on the first day and the eighth day . Then, the 21-day cycle is completed, and the next cycle begins again.
- The first time the medicine is given, it can take about 3 hours.
- After that, you can finish it within 1-2 hours.
Before giving the medicine, your doctor will give you acetaminophen (like Panadol), antihistamines (like Pyridoxine) , and possibly steroids to prevent things like fever, nausea, and skin allergies.
What research has been done on the effectiveness of this medicine?
Several large clinical studies have been conducted to confirm the safety and efficacy of Trodelvy. ASCENT and TROPiCS-02 are two of the main studies.
These studies compared patients who received Trodelvy with patients who received standard chemotherapy. They focused on two main points:
- Progression-Free Survival (PFS): This is the length of time a patient lives without the cancer getting worse.
- Overall Survival (OS): This means the total time the patient lives.
Beneficial results shown by research
Both of these studies showed very good results.
ASCENT study (for TNBC cancer):
- While patients who took Trodelvy had their cancer controlled for 5.6 months without getting worse, it was only 1.7 months for those who took regular medication.
- The overall survival (OS) of patients who took Trodelvy was about 11.8 months , compared to 6.9 months in the other group.
TROPiCS-02 study (for HR+/HER2- cancers):
- While patients who took Trodelvy had their cancer controlled for 5.5 months without spreading, it was 4 months for those who took the usual medication.
- Patients who took Trodelvy lived an average of 3.2 months longer than others (14.4 months vs 11.2 months).
- The rate of tumor shrinkage was also higher among those who took Trodelvy (21% vs 14%).
Simply put, both studies showed that patients treated with Trodelvy lived longer with disease control and lived longer overall than patients treated with standard chemotherapy.
Side effects of medication and how to deal with them
Like any medication, Trodelvy can have side effects. The most important thing is to be aware of them and work with your doctor to manage them. Here are the most common side effects and what you can do about them.
| Side Effect | Description and management |
|---|---|
| Decreased white blood cells (Neutropenia) | This increases the risk of infection. Your doctor will test your blood. If you develop a fever, it could be a sign of infection, so tell your doctor right away. |
| Diarrhea | Loose stools. Drink plenty of fluids like water and broth. If diarrhea is severe or lasts for several days, be sure to tell your doctor . |
| Nausea and vomiting | Stay away from strong smells. Eat small meals rather than large meals. The doctor will prescribe medication for nausea. |
| Fatigue | It is normal to feel very tired. Get plenty of rest. Engage in light exercise with your doctor's approval. |
| Hair loss | For a while, some or all of your hair may fall out. This is temporary. If necessary, you can use a wig or head covering. |
| Decreased red blood cells (Anemia) | This can cause a feeling of weakness and fatigue. The doctor will test your blood and prescribe the necessary treatment. |
Special awareness about pregnancy and breastfeeding
Trodelvy treatment is not recommended during pregnancy . It may harm an unborn baby. Therefore, it is imperative to use an effective form of birth control during treatment and for 6 months after the last dose. Breastfeeding mothers should refrain from breastfeeding during treatment and for 1 month after the last dose.
Are there any interactions with other medications and foods?
There are no specific food interactions reported for Trodelvy. However, drinking alcohol may make side effects such as nausea, diarrhea, and fatigue worse.
Interactions with other medications may occur. Some medications may reduce the effects of Trodelvy, while others may increase the effects of Trodelvy and make side effects worse.
Therefore, be sure to tell your doctor about all the medications you take, whether they are over-the-counter, vitamins, or even herbal supplements. This is very important.
Who should not use this medicine?
Do not use this medicine if you are allergic to Trodelvy or any of its ingredients. Some people may have severe allergic reactions. Watch for symptoms like these:
- Difficulty breathing (wheezing)
- Swelling of the face, throat
- Low blood pressure
- Severe skin rash
If you experience any of these symptoms, it is an emergency. Go to the nearest hospital Emergency Department (ETU) immediately.
Things to tell your doctor before starting treatment
- Liver disease: Tell your doctor if you have any liver disease.
- UGT1A1 gene: Some people have a variant of this gene, which puts them at higher risk of side effects like low white blood cell count. Your doctor may test for this if necessary.
- Planning to become pregnant: Tell your doctor if you or your partner are planning to become pregnant. If the male partner is taking treatment, they should use a form of birth control, such as condoms, during treatment and for 3 months after the last dose.
Take-Home Message
- Trodelvy is a targeted therapy used for certain types of advanced breast cancer.
- It works differently from traditional chemotherapy, targeting cancer cells directly.
- This treatment is given through a vein in a hospital.
- Side effects such as diarrhea and low white blood cell count are possible, and it is important to work closely with your doctor to manage them.
- Inform your doctor about all other medications, vitamins, and even traditional herbs you are taking.
- This treatment is not safe during pregnancy or breastfeeding.
- Please discuss whether this treatment is right for you and all related decisions with your oncologist.
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