Real-world outcomes of sacituzumab govitecan in patients with pretreated triple-negative breast cancer and brain metastases: data from CEBCC-102 study.

BACKGROUND

Patients with metastatic triple-negative breast cancer (mTNBC) and brain metastases (BM) have poor prognosis and limited treatment options. In the ASCENT trial, sacituzumab govitecan (SG) showed modest progression-free survival (PFS) benefit but no overall survival (OS) advantage in a subgroup with stable BM. To address the limited evidence, we evaluated SGs effectiveness and safety in a real-world cohort. MATERIALS AND

METHODS

This retrospective multicenter study included patients with mTNBC and radiologically confirmed BM treated with ≥2 L SG at 13 centers in the Czech Republic, Poland and Slovakia. Clinical data included baseline features, BM characteristics, CNS-directed therapies, treatment response and safety. PFS and OS were assessed using Kaplan-Meier estimates; univariable Cox models evaluated the impact of BM burden on survival.

RESULTS

29 women were included. Median number and size of BM were 3 and 16.5 mm, respectively. Prior neurosurgery was performed in 4 patients (14.3%) and radiotherapy in 28 (89.3%). Most had received ≥2 prior systemic therapies. After a median follow-up of 6.05 months, median OS was 8.9 months and PFS 3.09 months. Overall response rate was 30.8%, with CNS progression in 23.1%. Neither BM number nor size significantly affected survival. SG required dose delays in 51.7% and reductions in 37.9%; 7.7% discontinued due to toxicity. No unexpected safety signals were observed.

CONCLUSIONS

SG showed activity and manageable safety in real-world mTNBC with BM, with PFS and OS comparable or superior to the ASCENT BM subgroup. Outcomes were unaffected by BM burden, indicating SG efficacy irrespective of its extent.