Title: Sacituzumab govitecan for treating unresectable locally advanced or metastatic triple-negative breast cancer after two or more therapies ID3942
Funder: Department of Health and Social Care

Abstract: Breast cancer arises from the tissues of the ducts or lobules of the breast. ‘Locally advanced’ breast cancer generally refers to cancer that has spread from the breast to lymph nodes close to the breast, to the skin of the breast, or to the chest wall (stage 3). When the cancer has spread beyond the breast to other parts of the body such as the bones, liver, lung, and brain, it is known as metastatic breast cancer (stage 4)._x000D_ _x000D_ Over 46,100 people were diagnosed with breast cancer in England in 2017 and there were approximately 9,600 deaths from breast cancer in England in 2018. [1],[2] Around 15% of breast cancers are triple-negative breast cancers whereby the cancer cells test negative for oestrogen receptors, progesterone receptors (hormone-receptornegative cancer) and human epidermal growth factor receptor 2 (HER2-negative cancer). [3]_x000D_ _x000D_ Triple-negative breast cancer is associated with poor prognosis with high risk of relapse and short progression-free survival and overall survival. It can be particularly aggressive, is more likely to recur than other subtypes of breast cancer and is associated with poorer survival. It is diagnosed more frequently in younger people, black people, and people with BRCA1 mutations (a gene on chromosome 17 that normally helps to supress cell growth, which is an inherited gene mutation that may increase the risk of breast cancer). [3],[4],[5]_x000D_ _x000D_ NICE clinical guideline 81 (CG81) recommends systemic sequential therapy for most patients with advanced breast cancer having chemotherapy. Where anthracyclines are not suitable (because they are contraindicated or because of prior anthracycline treatment) the sequencing should follow: single-agent docetaxel as a first-line treatment, single-agent vinorelbine or capecitabine as second line treatment, and single-agent capecitabine or vinorelbine (whichever was not used as second line treatment) as third line treatment. In addition, NICE technology appraisal 423 recommends eribulin as an option for treating locally advanced or metastatic breast cancer when it has progressed after at least two chemotherapy regimens._x000D_ _x000D_ References_x000D_ 1 Office for National Statistics (2019) Cancer registration statistics, England, 2017. Accessed July 2021._x000D_ 2 Cancer research UK (2018) Breast cancer mortality statistics. Accessed July 2021._x000D_ 3 Cancer research UK (2020) Triple negative breast cancer. Accessed July 2021_x000D_ 4 Couch FJ, Hart SN, Sharma P et al. Inherited mutations in 17 breast cancer susceptibility genes among a large triple-negative breast cancer cohort unselected for family history of breast cancer. Journal of Clinical Oncology 2015;33(4):304-311_x000D_ 5 Macmillan Cancer Support (2021) Triple negative breast cancer. Accessed July 2021

Lay abstract: To appraise the clinical and cost effectiveness of sacituzumab govitecan within its marketing authorisation for treating unresectable locally advanced or metastatic triple-negative breast cancer after two or more therapies.

Research activity codes: 6.1 PHARMACEUTICALS
Health categories: CANCER AND NEOPLASMS