New Protocol: Sacituzumab Govitecan + Pembrolizumab for Triple-Negative Metastatic Breast Cancer

ASCENT-04 phase 3 trial showed that sacituzumab govitecan plus pembrolizumab significantly improved progression-free survival compared to chemotherapy plus pembrolizumab in patients with PD-L1-positive advanced triple-negative breast cancer. Objective response rates were higher, and responses were more durable with the combination treatment. Safety profiles were consistent with known effects of the drugs.

  • Study

    Phase 3, open-label, international trial [ASCENT-04/KEYNOTE-D19]
    Untreated, unresectable/metastatic triple-negative breast cancer, PD-L1-positive
    Sacituzumab govitecan plus pembrolizumab (n=221) vs chemotherapy plus pembrolizumab (n=222)



  • Efficacy

    ORR: 60% vs 53% (sacituzumab + pembro vs. chemo + pembro)
    mPFS: 11.2 mos vs 7.8 mos (HR 0.65 [0.51-0.84])
    mDOR: 16.5 mos vs 9.2 mos
    Overall survival immature



  • Safety

    Grade >=3 AE: neutropenia (43% vs 45%), diarrhea (10% vs 2%), anemia (7% vs 16%)
    Treatment discontinuation: 12% vs 31%
    Deaths due to AEs: 3% vs 3%


  • Engl J Med 2026;394:354-66

    Tolaney SM, de Azambuja E, Kalinsky K Sacituzumab Govitecan plus Pembrolizumab for Advanced Triple-Negative Breast Cancer

    http://doi.org/10.1056/NEJMoa2508959

    Reviewed by Ulas D. Bayraktar, MD on Feb 19, 2026

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