Trodelvy Outperforms Chemotherapy in Major Clinical Trial
A new study is offering hope for patients diagnosed with one of the most aggressive and deadly forms of breast cancer. The antibody-drug conjugate Trodelvy has demonstrated significantly better outcomes than standard chemotherapy in patients with advanced triple-negative breast cancer (TNBC) who are not eligible for immunotherapy, according to findings published in the New England Journal of Medicine.
“The trial delivers compelling evidence that Trodelvy is clinically superior to chemotherapy as a first-line treatment in newly diagnosed metastatic TNBC,” said Dr. Francisco J. Esteva, chief of Hematology & Medical Oncology at Lenox Hill Hospital, who was not involved in the study. “These results support Trodelvy as a potential new standard of care.”
A Targeted Approach to an Aggressive Cancer
Triple-negative breast cancer accounts for roughly 15% of all breast cancer cases and is known for its rapid progression and limited treatment options. Because TNBC lacks the three major hormone receptors that other breast cancers rely on, it cannot be treated with hormonal therapy or HER2-targeted drugs. The five-year survival rate for metastatic TNBC patients remains dismal — around 15%.
In the trial, patients with locally advanced or metastatic TNBC received either Trodelvy or traditional chemotherapy. The results showed clear advantages for the new drug: progression-free survival averaged 9.7 months with Trodelvy compared to 6.9 months with chemotherapy, and overall response durability reached 12.2 months versus 7.2 months.
Trodelvy functions as a “smart bomb” by attaching to surface proteins on tumor cells. Once bound, it delivers a toxic payload directly inside the cancer cell, destroying it while sparing most healthy tissues. “This targeted action underpins its designation as a ‘smart bomb’ and contributes to its strong efficacy and safety profile,” Esteva explained.
Better Tolerability and Broader Benefits
Tolerability proved another major advantage. Only 4% of patients discontinued Trodelvy due to side effects, compared with 12% in the chemotherapy group. This lower toxicity rate suggests the treatment can maintain patients’ strength and improve quality of life during therapy.
“Trodelvy demonstrated consistent efficacy across all predefined subgroups, including those with poor prognostic factors such as liver metastases and early relapse,” Esteva said. “Agents like Trodelvy provide more sustained disease control, avoid classic chemotherapy toxicities such as peripheral neuropathy, and help patients qualify for second-line therapies.”
In earlier studies, when Trodelvy was used alongside Merck’s Keytruda (pembrolizumab), the combination reduced the risk of disease progression by 35%. Researchers believe that integrating Trodelvy earlier in the treatment timeline could amplify survival benefits even further.
A Paradigm Shift in Breast Cancer Care
Experts view Trodelvy as a potential turning point in how TNBC is treated. “This represents a paradigm shift in care,” Esteva said. “By incorporating Trodelvy earlier in treatment, we are positioning patients to live longer and live better.”
The drug supports patient survival in three key ways: delaying disease progression during critical stages, improving access to subsequent therapies, and reducing treatment attrition due to severe side effects. Together, these outcomes suggest Trodelvy could extend survival while maintaining patients’ quality of life — an elusive goal for TNBC patients for decades.
While the trial’s success marks an important milestone, further research and regulatory review are still needed before Trodelvy becomes the new standard of care. Nonetheless, oncologists remain optimistic that this “smart bomb” therapy could redefine treatment outcomes for one of the toughest cancers to fight.