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5 treatment settings, 4 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.
Pembrolizumab with chemotherapy (KEYNOTE-355) or with sacituzumab govitecan (ASCENT-04).
Pembrolizumab is a PD-1 blocking antibody approved in more than 40 settings, from melanoma and lung cancer to the first tumour-agnostic approval for mismatch-repair-deficient tumours in 2017, and before and after surgery in triple-negative breast cancer. A subcutaneous form arrived in 2025, and it is the backbone partner for ADCs and personalised neoantigen vaccines.
Sacituzumab govitecan carries chemotherapy to cancer cells bearing TROP2. It is FDA-approved for specific advanced breast-cancer settings, including two first-line triple-negative indications.
OS HR 0.73 in CPS ≥10.
FDA reports 443 randomized patients with previously untreated advanced TNBC and PD-L1 CPS at least 10. Sacituzumab govitecan plus pembrolizumab versus chemotherapy plus pembrolizumab improved median PFS, 11.2 versus 7.8 months (HR 0.65, 95% CI 0.51 to 0.84). The June 24, 2026 approval concerns advanced disease, not postoperative recurrence prevention.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Hypothyroidism (immune-mediated) · Pooled monotherapy data, >2,800 patients | 8% | - |
| Pneumonitis (immune-mediated) · Pooled monotherapy data, >2,800 patients | 3.4% | - |
| Colitis (immune-mediated) · Pooled monotherapy data, >2,800 patients | 1.7% | - |
| Hepatitis (immune-mediated) · Pooled monotherapy data, >2,800 patients | 0.7% | - |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia (grade 3 or higher) · ASCENT, sacituzumab arm; 33 percent with chemotherapy | - | 51% |
| Neutropenia · ASCENT, Trodelvy arm, n=258 | 78% | 49% |
| Diarrhoea · ASCENT, Trodelvy arm, n=258 | 59% | 11% |
| Diarrhoea (grade 3 or higher) · ASCENT; below 1 percent with chemotherapy | - | 10% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Datopotamab deruxtecan (TROPION-Breast02) or sacituzumab govitecan (ASCENT-03); a taxane or platinum where antibody-drug conjugates are unavailable.
Datopotamab deruxtecan delivers chemotherapy to cells bearing TROP2. Its FDA approvals cover specific advanced breast-cancer and EGFR-mutated lung-cancer settings.
Sacituzumab govitecan carries chemotherapy to cancer cells bearing TROP2. It is FDA-approved for specific advanced breast-cancer settings, including two first-line triple-negative indications.
A microtubule poison discovered in the Pacific yew tree, among the most used chemotherapies in breast, lung, and ovarian cancer.
Carboplatin is a platinum chemotherapy that crosslinks DNA; it is part of the standard pre-surgery regimen for triple-negative breast cancer.
TROPION-Breast02 randomized 644 patients (323/321) with previously untreated advanced TNBC for whom PD-1/PD-L1 inhibitor therapy was unsuitable. FDA reports median PFS 10.8 versus 5.6 months (HR 0.57, 95% CI 0.47 to 0.69) and OS 23.7 versus 18.7 months (HR 0.79, 95% CI 0.64 to 0.98). FDA approved the advanced-disease indication May 22, 2026. These outcomes do not establish postoperative benefit or provide a head-to-head comparison against sacituzumab govitecan.
FDA reports 558 randomized patients with previously untreated unresectable locally advanced or metastatic TNBC who were not candidates for PD-1/PD-L1 therapy. Sacituzumab govitecan versus chemotherapy improved median PFS, 9.7 versus 6.9 months (HR 0.62, 95% CI 0.50 to 0.77). ClinicalTrials.gov lists 623 actual participants; the difference from the FDA efficacy-study population is retained without inventing a reconciliation. These are advanced-disease outcomes, not postoperative recurrence prevention.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Stomatitis · TROPION-Breast01, n=360 | 59% | 7% |
| Fatigue · TROPION-Breast01, n=360 | 44% | 4.2% |
| Nausea · TROPION-Breast01, n=360 | 56% | 1.4% |
| Keratitis · TROPION-Breast01, n=360 | 24% | 1.1% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia (grade 3 or higher) · ASCENT, sacituzumab arm; 33 percent with chemotherapy | - | 51% |
| Neutropenia · ASCENT, Trodelvy arm, n=258 | 78% | 49% |
| Diarrhoea · ASCENT, Trodelvy arm, n=258 | 59% | 11% |
| Diarrhoea (grade 3 or higher) · ASCENT; below 1 percent with chemotherapy | - | 10% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Olaparib (OlympiAD) or talazoparib (EMBRACA) after or instead of first-line chemotherapy; platinum chemotherapy is also more active.
Olaparib was the first PARP inhibitor, and turned an inherited BRCA mutation from a risk factor into a drug target, including after surgery in breast cancer.
Talazoparib is a DNA-repair inhibitor for selected inherited-BRCA breast cancers and, with hormone treatment, selected advanced prostate cancers.
Carboplatin is a platinum chemotherapy that crosslinks DNA; it is part of the standard pre-surgery regimen for triple-negative breast cancer.
PFS 7.0 vs 4.2 months, HR 0.58; OS 19.3 vs 17.1 months, not significant.
PFS 8.6 vs 5.6 months, HR 0.54; OS HR 0.85, not significant.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Anaemia · OlympiA adjuvant, n=911 | 24% | 9% |
| Neutropenia · OlympiA adjuvant, n=911 | 16% | 5% |
| Leukopenia · OlympiA adjuvant, n=911 | 17% | 3% |
| Fatigue · OlympiA adjuvant, n=911 | 42% | 1.8% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Whichever TROP2 antibody-drug conjugate has not been used (ASCENT); trastuzumab deruxtecan for HER2-low tumours (DESTINY-Breast04); izalontamab brengitecan where available; eribulin, capecitabine or gemcitabine with carboplatin.
Sacituzumab govitecan carries chemotherapy to cancer cells bearing TROP2. It is FDA-approved for specific advanced breast-cancer settings, including two first-line triple-negative indications.
Trastuzumab deruxtecan (Enhertu) is the most successful ADC ever. It redefined HER2 by working in tumours with only tiny amounts of the protein, and in 2026 moved into early-stage breast cancer.
Izalontamab brengitecan is the first bispecific ADC to succeed in a phase 3 trial, hitting two growth receptors at once in triple-negative breast cancer.
A sea-sponge-derived chemotherapy that extended survival in heavily pretreated breast cancer and in liposarcoma, where almost nothing else had.
Capecitabine (Xeloda) is a tablet form of the chemotherapy fluorouracil. It is a backbone of treatment for bowel cancer and a standard option in advanced breast cancer.
A versatile chemotherapy used in pancreatic, bladder, lung, ovarian, breast and biliary cancers, in nasopharyngeal cancer, and as a bladder instillation.
OS 12.1 vs 6.7 months, HR 0.48.
OS HR 0.64.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia (grade 3 or higher) · ASCENT, sacituzumab arm; 33 percent with chemotherapy | - | 51% |
| Neutropenia · ASCENT, Trodelvy arm, n=258 | 78% | 49% |
| Diarrhoea · ASCENT, Trodelvy arm, n=258 | 59% | 11% |
| Diarrhoea (grade 3 or higher) · ASCENT; below 1 percent with chemotherapy | - | 10% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia · DESTINY-Breast03/04; all-grade rates ≥20% per label | - | 18% |
| Nausea · DESTINY-Breast03/04; all-grade rates ≥20% per label | - | 7% |
| Anaemia · DESTINY-Breast03/04; all-grade rates ≥20% per label | - | 7% |
| Fatigue · DESTINY-Breast03/04; all-grade rates ≥20% per label | - | 6% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Stereotactic radiosurgery or whole-brain radiotherapy with continued systemic therapy; antibody-drug conjugates have early evidence of intracranial activity.
A single very high dose, or a few doses, aimed at a small brain or spine target with millimetre precision, replacing whole-brain radiotherapy for most brain metastases.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
Add these to your appointment list, or take the full question set for this cancer.