Introduction Metastatic triple-negative breast cancer (TNBC) is an aggressive 
cancer with poor survival that is difficult to treat due to a lack of targeted 
options. Conventional therapies targeting hormone receptors (HR) and human 
epidermal growth factor 2 (HER2) are ineffective and often chemotherapy is 
standard-of-care. Sacituzumab govitecan is an antibody drug conjugate (ADC) 
comprised of an active metabolite of irinotecan, SN-38, bound to a humanized 
monoclonal antibody targeting trophoblastic cell-surface antigen 2 (Trop-2). 
Trop-2 is highly expressed on the surface of TNBC cells, making it an attractive 
target. Areas covered We explore the mechanism, pharmacology, efficacy, safety, 
and tolerability of sacituzumab govitecan. A literature search was conducted via 
PubMed using keywords such as 'sacituzumab govitecan,' and 'metastatic TNBC.' 
Expert opinion Sacituzumab govitecan has promising survival benefits in patients 
with previously treated mTNBC based on data from the ASCENT trial. Common 
adverse effects were neutropenia, diarrhea, and nausea, however these effects 
were manageable with supportive care. Sacituzumab govitecan has shown promise in 
cancers outside of TNBC, such as urothelial and lung and is being evaluated in 
HR-positive breast cancers. It is likely we will see this therapy used in 
combination with other novel targeted agents as current clinical trials mature.