TROPiCS-02

TROPiCS-02, trial NCT03901339 sponsored by Gilead and reported in 2022, showed that the TROP2 antibody-drug conjugate sacituzumab govitecan extends survival in heavily pretreated HR-positive, HER2-negative metastatic breast cancer. It randomised 543 women who had received endocrine therapy, a CDK4/6 inhibitor and two to four chemotherapies to sacituzumab govitecan or chemotherapy, met its primary progression-free survival endpoint and showed an overall survival benefit of a few months, leading to approval in February 2023 and establishing antibody-drug conjugates in this disease after chemotherapy. OnCo links it to TROP2 as a target, sacituzumab govitecan and Hope S. Rugo. Whether TROP2 ADCs should move earlier, before chemotherapy, is the open question.