Gilead Sciences, Inc. shared positive data from the Phase 3 ASCENT-03 study demonstrating a highly statistically significant and clinically meaningful improvement in progression-free survival (PFS) for Trodelvy compared to chemotherapy as first-line treatment in patients with metastatic triple-negative breast cancer (TNBC) who are not candidates for PD-1/PD-L1 inhibitors. These findings will be presented today during a late-breaking oral session at the 2025 European Society for Medical Oncology (ESMO) Congress (Abstract #LBA20) and simultaneously published in The New England Journal of Medicine.
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ASCENT-03 successfully met its primary endpoint of PFS with a 38% reduced risk of disease progression or death for Trodelvy versus chemotherapy (HR: 0.62; p<0.0001). Median PFS with Trodelvy was 9.7 months versus 6.9 months for chemotherapy. The PFS results for Trodelvy versus chemotherapy were consistent across prespecified subgroups, including among patients with poorer prognosis (such as those whose cancer recurred less than one year after treatment in the curative setting) and regardless of chemotherapy chosen.
“Patients with metastatic TNBC who are ineligible for immunotherapy face an especially poor prognosis, with limited treatment options and fast disease progression,” said Dr. Javier Cortés, Head of the International Breast Cancer Center in Spain and principal investigator of the ASCENT-03 study. “The ability of sacituzumab govitecan to significantly delay death and progression could represent the first major treatment advance for this patient population in the 20 years since TNBC was defined, marking an historic shift and establishing a potential new standard of care.”
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The objective response rate (ORR) was 48% with Trodelvy and 46% with chemotherapy. Median duration of response (DOR) was substantially longer with Trodelvy. Among patients with confirmed complete or partial responses, DOR for Trodelvy was 12.2 months compared to 7.2 months with chemotherapy.
Overall survival (OS) data were not mature at the time of PFS primary analysis. Gilead will continue to monitor OS outcomes, with ongoing patient follow-up and further analysis planned.
These results complement the recent presentation of ASCENT-04/KEYNOTE-D19, which showed a significant PFS benefit for Trodelvy plus Keytruda in PD-L1+ first-line metastatic TNBC. Gilead is engaging with the U.S. Food and Drug Administration and other global regulators regarding both data sets.
“ASCENT-03 is the second Phase 3 trial with a Trodelvy-based regimen to show superior progression-free survival over chemotherapy in first-line metastatic TNBC, highlighting its potential to improve outcomes for patients with limited treatment options,” said Dietmar Berger, MD, PhD, Chief Medical Officer, Gilead Sciences. “With these potentially practice-changing results, Trodelvy is poised to transform the first-line metastatic TNBC treatment landscape, offering a much-needed alternative to chemotherapy.”
The safety profile of Trodelvy in the ASCENT-03 study was consistent with prior studies, and no new safety signals were identified in this patient population. The most frequent grade ≥3 treatment-emergent adverse events were neutropenia (43%) and diarrhea (9%) with Trodelvy and neutropenia (41%) and anemia (16%) with chemotherapy. Fewer patients discontinued treatment due to adverse events on Trodelvy than with chemotherapy (4% vs. 12%).
Healthcare professionals have well-established experience with Trodelvy, with more than 60,000 breast cancer patients treated across 50+ countries over the past five years. It remains the only Trop-2-directed antibody-drug conjugate (ADC) to demonstrate meaningful survival benefits in both 2L+ metastatic TNBC and pre-treated HR+/HER2- metastatic breast cancer. It is also the only ADC with four positive Phase 3 trials in HER2- mBC (IHC 0, IHC 1+, or IHC 2+/ISH–).
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