Therapeutic options for patients with metastatic breast cancer become increasingly limited after multiple lines of systemic treatment. Sacituzumab govitecan (SG), a Trop-2–targeting antibody–drug conjugate, has been incorporated into treatment algorithms for metastatic triple-negative breast cancer and more recently for hormone receptor-positive/HER2-negative disease. However, evidence describing its performance in routine oncology practice remains sparse. This retrospective multicenter study examined real-world treatment outcomes, toxicity, and clinical factors associated with survival in patients receiving SG. Clinical records of 68 patients treated with SG between 2022 and 2025 at participating oncology centers in Turkey were analyzed. Patients with triple-negative disease had previously received at least one chemotherapy regimen, whereas those with hormone receptor-positive/HER2-negative disease had undergone endocrine therapy combined with CDK4/6 inhibition and a minimum of two prior chemotherapy lines. Treatment effectiveness was assessed using progression-free survival, overall survival, and radiologic response. Multivariable regression analyses were conducted to explore predictors of outcome. Safety data were collected and graded using CTCAE version 5.0 criteria. The study population consisted of 35 patients with triple-negative disease and 33 with hormone receptor-positive/HER2-negative disease. Survival outcomes were comparable between subgroups, with median progression-free and overall survival durations of 6.1 months and 12.5 months, respectively. Tumor response was observed in more than half of the cohort, including complete responses in a subset of patients. Poor functional status and the presence of hepatic metastases were independently associated with inferior survival outcomes. Previous exposure to immune checkpoint inhibitors did not compromise treatment benefit. Adverse events were generally manageable, with hematologic toxicity, gastrointestinal symptoms, and alopecia occurring most frequently. Permanent treatment cessation due to toxicity was uncommon. In a real-life clinical setting, SG demonstrated consistent activity and an acceptable safety profile across two major metastatic breast cancer subtypes. Although the observed outcomes align with those reported in prospective trials, the absence of a control group limits causal interpretation. Importantly, this analysis contributes early real-world evidence supporting the use of SG in hormone receptor-positive/HER2-negative metastatic breast cancer and highlights the need for further prospective and biomarker-driven research.
