Study of Sacituzumab Govitecan Versus Physician's Choice of Treatment in Participants With Urothelial Cancer That Cannot Be Removed or Has Spread

Summary

The primary objective of this study is to assess overall survival (OS) with sacituzumab govitecan-hziy in comparison with treatment of physician's choice (TPC) in participants with metastatic or locally advanced unresectable urothelial cancer (UC).

Timeline

Start

2021-01-13

Primary completion

2025-07-04

Completion

2025-07-04

Outcome

Missed primary endpoint

registry analysis (superiority test); Sacituzumab Govitecan-hziy (SG) vs Treatment of Physician's Choice; p = 0.0870; Stratified Hazard Ratio 0.86 (95% CI 0.73 to 1.02); NCT04527991 ↗

paper Overall, participants who received sacituzumab govitecan did not live significantly longer than those who received chemotherapy. PMID 41277126 ↗

Publications

• Background Powles T, Tagawa S, Vulsteke C, Gross-Goupil M, Park SH, Necchi A, De Santis M, Duran I, Morales-Barrera R, Guo J, Sternberg CN, Bellmunt J, Goebell PJ, Kovalenko M, Boateng F, Sierecki M, Wang L, Sima CS, Waldes J, Loriot Y, Grivas P. Sacituzumab govitecan in advanced urothelial carcinoma: TROPiCS-04, a phase III randomized trial. Ann Oncol. 2025 May;36(5):561-571. doi: 10.1016/j.annonc.2025.01.011. Epub 2025 Feb 11.
• Background Grivas P, Tagawa S, Bellmunt J, De Santis M, Duran I, Goebell PJ, et al. TROPiCS-04: Study of Sacituzumab Govitecan in Metastatic or Locally Advanced Unresectable Urothelial Cancer That Has Progressed After Platinum and Checkpoint Inhibitor Therapy. [Poster TPS498]. American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO GU); 2021 February 11-13; Virtual meeting.
• Background Grivas P., Powles T., Vulsteke C., Gross-Goupil M., Park S. et al. LBA9 TROPiCS-04, a randomized phase III study of sacituzumab govitecan (SG) vs chemotherapy (CT) in pretreated advanced urothelial carcinoma (aUC): Overall survival (OS) and safety analysis. Annals of Oncology, Volume 35, Supplement 4, S1505-S1507, December 2024.
• Background Vulsteke C, Grivas P, Tagawa ST, Bellmunt J, De Santis M, Duran I, et al. TROPiCS-04: Study of Sacituzumab Govitecan (SG) in Patients (Pts) With Locally Advanced (LA) Unresectable or M etastatic Urothelial Cancer (mUC) That Has Progressed After Prior Platinum (PLT) and Checkpoint Inhibitor (CPI) Therapy. [Poster TPS582]. American Society of Clinical Oncology Genitourinary (ASCO-GU); 2022 February 17-19; Annual Meeting.
• Powles T, Tagawa ST, Vulsteke C, Gross-Goupil M, Park SH, Necchi A, De Santis M, Duran I, Morales-Barrera R, Guo J, Sternberg CN, Bellmunt J, Goebell PJ, Kovalenko M, Boateng F, Sierecki M, Wang L, Sima CS, Waldes J, Bangs R, Loriot Y, Grivas P. A plain language summary of the TROPiCS-04 study: sacituzumab govitecan use after platinum-based chemotherapy and immunotherapy in people with locally advanced or metastatic cancer of the bladder, urethra, or upper urinary tract. Future Oncol. 2025 Dec;21(28):3593-3610. doi: 10.1080/14796694.2025.2579003. Epub 2025 Nov 23.
• Klumper N, Cox A, Sjodahl G, Roghmann F, Bolenz C, Hartmann A, Grunwald V, Faltas BM, Holzel M, Eckstein M. Pre-treatment metastatic biopsy: a step towards precision oncology for urothelial cancer. Nat Rev Urol. 2025 May;22(5):256-267. doi: 10.1038/s41585-024-00951-2. Epub 2024 Oct 29.

Drugs

Evaluation	Drug	Modality	Dose	Route
Comparator	Docetaxel	Small molecule	75 mg/m2	Intravenous
Comparator	Paclitaxel	Small molecule	175 mg/m2	Intravenous
Subject	Sacituzumab Govitecan	Monoclonal antibody	10 mg/kg	Intravenous
Comparator	Vinflunine	Small molecule	320 mg/m2	Intravenous

Indications