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Systemic Anti-Cancer Therapy Regimen Library

Home > BR Metastatic - sacituzumab govitecan

BR Metastatic - sacituzumab govitecan

Treatment Overview


Cycle 1 (and all further cycles) - 21 days

Cycle length:
21

sacituzumab govitecan:

  • If the initial dose is well tolerated, subsequent doses may be administered over 60 to 120 minutes.
  • An observation period of at least 30 minutes post-infusion is recommended.

Cycle details

Cycle 1 (and all further cycles) - 21 days

Medication Dose Route Days Max Duration
olanzapine * 5 mg oral administration 1 to 4,
8 to 11
aprepitant 125 mg oral administration 1, 8
aprepitant 80 mg oral administration 2, 3, 9,
10
dexamethasone * 12 mg oral administration 1, 8
dexamethasone * 8 mg oral administration 2, 3, 4,
9, 10, 11
ondansetron 8 mg oral administration 1, 8
loratadine * 10 mg oral administration 1, 8
famotidine * 20 mg oral administration 1, 8
paracetamol * 1000 mg flat dosing oral administration 1, 8
sacituzumab govitecan 10 mg/kg intravenous 1, 8 3 hours
atropine sulfate * 600 microgram intravenous 1 2 minutes
ondansetron 8 mg oral administration 1, 8
cyclIZINE 50 mg Three times daily oral administration 1
loperamide 2 mg oral administration 1

sacituzumab govitecan:

  • If the initial dose is well tolerated, subsequent doses may be administered over 60 to 120 minutes.
  • An observation period of at least 30 minutes post-infusion is recommended.

Full details

Cycle 1 (and all further cycles) - 21 days

Day: 1

Medication Dose Route Max duration Details
olanzapine * 5 mg oral administration
Instructions:

ONE hour prior to chemotherapy.

  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
  • Some centres may choose to omit pre-chemotherapy dose or advise patient to take the night before chemotherapy if patient has to drive to appointment.
aprepitant 125 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
dexamethasone * 12 mg oral administration
Instructions:

ONE hour prior to chemotherapy with food.
ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.
loratadine * 10 mg oral administration
Instructions:

ONE hour prior to sacituzumab govitecan infusion.
famotidine * 20 mg oral administration
Instructions:

ONE hour prior to sacituzumab govitecan infusion.

  • Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine.
paracetamol * 1000 mg flat dosing oral administration
Instructions:

ONE hour prior to sacituzumab govitecan infusion.
sacituzumab govitecan 10 mg/kg intravenous 3 hours
Instructions:
  • If the initial dose is well tolerated, subsequent doses may be administered over 60 to 120 minutes.
  • An observation period of at least 30 minutes post-infusion is recommended.
atropine sulfate * 600 microgram intravenous 2 minutes
Instructions:

Only if required for acute diarrhoea or cholinergic symptoms.

  • Alternatively, dose may be administered subcutaneously.
  • 600 microgram = 0.6 mg.
  • Some centres may wish to give a reduced dose of 300 microgram (= 0.3 mg) in line with institutional policy.
  • Dose may be repeated up to a maximum dose of 1200 microgram (= 1.2 mg).
ondansetron 8 mg oral administration
Instructions:

EIGHT hours after chemotherapy OR before bed.
cyclIZINE 50 mg Three times daily oral administration
Instructions:

When required for nausea and/or vomiting.

  • Warning: may cause drowsiness.
  • Consider starting dose at 25 mg and increasing as tolerated/required.
  • The choice of rescue antiemetic may be substituted to reflect institutional policy or individual patient characteristics.
  • Note that domperidone is not recommended in combination with olanzapine and ondansetron due to potential risk of QT prolongation.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
olanzapine * 5 mg oral administration
Instructions:

ONCE daily.

  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
aprepitant 80 mg oral administration
Instructions:
ONCE daily in the morning.
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

  • Dose and duration may be individualised at clinician’s discretion.

Day: 3

Medication Dose Route Max duration Details
olanzapine * 5 mg oral administration
Instructions:

ONCE daily.

  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
aprepitant 80 mg oral administration
Instructions:
ONCE daily in the morning.
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

  • Dose and duration may be individualised at clinician’s discretion.

Day: 4

Medication Dose Route Max duration Details
olanzapine * 5 mg oral administration
Instructions:

ONCE daily.

  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

  • Dose and duration may be individualised at clinician’s discretion.

Day: 8

Medication Dose Route Max duration Details
olanzapine * 5 mg oral administration
Instructions:

ONE hour prior to chemotherapy.

  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
  • Some centres may choose to omit pre-chemotherapy dose or advise patient to take the night before chemotherapy if patient has to drive to appointment.
aprepitant 125 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
dexamethasone * 12 mg oral administration
Instructions:

ONE hour prior to chemotherapy with food.
ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.
loratadine * 10 mg oral administration
Instructions:

ONE hour prior to sacituzumab govitecan infusion.
famotidine * 20 mg oral administration
Instructions:

ONE hour prior to sacituzumab govitecan infusion.

  • Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine.
paracetamol * 1000 mg flat dosing oral administration
Instructions:

ONE hour prior to sacituzumab govitecan infusion.
sacituzumab govitecan 10 mg/kg intravenous 3 hours
Instructions:
  • If the initial dose is well tolerated, subsequent doses may be administered over 60 to 120 minutes.
  • An observation period of at least 30 minutes post-infusion is recommended.
ondansetron 8 mg oral administration
Instructions:

EIGHT hours after chemotherapy OR before bed.

Day: 9

Medication Dose Route Max duration Details
olanzapine * 5 mg oral administration
Instructions:

ONCE daily.

  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
aprepitant 80 mg oral administration
Instructions:
ONCE daily in the morning.
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

  • Dose and duration may be individualised at clinician’s discretion.

Day: 10

Medication Dose Route Max duration Details
olanzapine * 5 mg oral administration
Instructions:

ONCE daily.

  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
aprepitant 80 mg oral administration
Instructions:
ONCE daily in the morning.
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

  • Dose and duration may be individualised at clinician’s discretion.

Day: 11

Medication Dose Route Max duration Details
olanzapine * 5 mg oral administration
Instructions:

ONCE daily.

  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

  • Dose and duration may be individualised at clinician’s discretion.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: High
Hypersensitivity / Infusion related reaction risk: High - routine premedication recommended

References

Bardia, A., S. A. Hurvitz, S. M. Tolaney, et al. 2021. "Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer." N Engl J Med 384(16):1529-1541., PMID: 33882206

Gilead Sciences Pty Ltd. - Trodelvy (sacituzumab govitecan) Australian Datasheet 6 September 2021. https://www.tga.gov.au/sites/default/files/auspar-sacituzumab-govitecan-220329-pi.pdf (Accessed 6 August 2024).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.