[Systemic therapy for advanced triple-negative breast cancer in older women: strategy optimization and effectiveness of sacituzumab govitecan.].

Triple-negative breast cancer (TNBC) represents a major challenge for clinical oncologists, due to lack of therapeutical targets deriving from hormone-receptors and/or HER2 receptor expression. Moreover, TNBC typically shows a more aggressive clinical behavior and less responsiveness to traditional chemotherapy. Last years, the clinical scenario improved thanks to the introduction of new therapeutical agents (such as immunotherapy for PD-L1 positive cancer or PARP inhibitors for germline mutated BRCA1/2 tumors) including antibody-drug conjugates (ADCs). Sacituzumab-govitecan (SG) was the first in class ADC able to demonstrate a statistically significant and clinically relevant benefit for all survival endpoints (including overall survival - OS) in advanced triple negative breast cancer, progressing on prior systemic therapy. The use of these new agents is particularly challenging in older patients, where efficacy and tolerability need to be balanced. Here, we describe a case of a 74-year-old patient with plurimetastatic triple-negative disease. SG has been administered as a second-line of therapy after local control of brain metastasis throughout radiotherapy and showed a durable response with a tolerable safety profile (nausea G2).