The NeoSTAR trial, published in March 2024, evaluated neoadjuvant sacituzumab govitecan (SG) in early-stage triple-negative breast cancer (TNBC). This study explored a response-guided approach using SG alone for four cycles. Results showed a 30% pathological complete response (pCR) rate and an overall response rate of 64%, with higher Ki-67 and tumor-infiltrating lymphocytes (TILs) associated with better responses. Adverse events were consistent with known SG toxicity, primarily nausea, fatigue, and neutropenia. The 2-year event-free survival (EFS) was 95%, reaching 100% among patients who achieved a pCR. Led by Dr. L. M. Spring, Dr. A. Bardia, and their team, this study supports further investigation into SG-based neoadjuvant strategies, including combination therapies with immunotherapy.
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