[Therapeutic success of sacituzumab govitecan in a patient with a primary diagnosis of triple-cancer: locally advanced triple-negative breast cancer, colon cancer and lung cancer.].

Triple-negative breast cancer (TNBC) remains the most aggressive form of breast cancer with a worse prognosis than other subtypes. Its high metastatic potential, limited availability of targeted therapies, and increased likelihood of being diagnosed at an advanced stage make it one of the most complex clinical challenges in breast cancer. Today, thanks to the advent of antibody-drug conjugates (ADCs), clinical outcomes have improved significantly. In this context, sacituzumab govitecan (SG) has been a true revolution. The case reported here illustrates how this therapeutic opportunity produced lasting clinical benefit in a highly complex patient with a triple neoplasm at presentation: inoperable locally advanced TNBC, operable colon cancer, and localized lung cancer. The chemorefractory patient (rapid progression of the first two lines of chemotherapy) received SG as a third-line treatment, showing a sustained response lasting more than 12 months and a significant benefit in terms of quality of life. This case highlights how a proper multidisciplinary approach can lead to a lasting clinical benefit from therapy. Deviating from the cases reported in clinical studies, it is important to underscore how, in this context, clinical choice prevailed. Given the locally advanced stage of the breast cancer, characterized by carcinomatous mastitis tending to ulceration and the high proliferation rate, compared to the localized stage of lung adenocarcinoma, a multidisciplinary decision was made to treat the more rapidly progressing disease, TNBC. In light of this, the importance of collecting clinical practice data to support the complex challenges we face daily is emphasized.