Aims
To evaluate the impact of the use of different supportive care measures to prevent and manage common adverse events (AEs) of Sacituzumab Govitecan (SG).
Methods
This was a retrospective single-centre cohort study which included all patients given at least one dose of SG between January 2022 and March 2023. Supportive measures to prevent and manage neutropenia, diarrhoea and nausea were evaluated alongside rates of AEs.
Results
9 patients were included with a median age of 60 (range 40 to 73). Neutropenia emerged as the main dose-limiting factor with 6 patients (67%) experiencing any grade neutropenia. 3 patients (33%) required dose reductions or delays due to neutropenia and there were no differences in rates whether prophylactic growth-factor support was given on day 2 or 9. Nausea cases were generally mild (only grade 1 and 2) and well managed with a 3-drug regimen (dexamethasone, 5-HT3 antagonist and NK-1 receptor antagonist) as pre-medications and metoclopramide for breakthrough nausea. Diarrhoea was consistently observed with 7 patients (78%) with diarrhoea (5 patients grade 1-2, 2 patients grade 3) and was usually worse after day 8 SG. 3 patients experienced alternating constipation and diarrhoea. Atropine as a pre-medication was only added on for 2 patients and loperamide was given to all patients to take at home if needed. Paracetamol, nizatidine and loratadine pre-medication was routinely given and there were no reports of hypersensitivity reactions.
Conclusions
Diarrhoea was a significant toxicity and the use of prophylactic atropine could be considered early on. Routine use of 3-drug anti-emetics and metoclopramide was effective in minimising nausea. Lastly, there was no observed differences in the prophylactic use of growth-factor support on either day 2 or 9 in rates of neutropenia. Further studies to include data from other centres will be useful to help optimise supportive care measures for SG.