What is Trodelvy ® and how does it work?
Trodelvy ® is made of 2 different drugs joined together
1. A monoclonal antibody drug: This attaches to Trop -2 receptors which are found on the outside of some cancer cells.
2. A chemotherapy drug: This stops all cells including cancer cells from growing and dividing
The monoclonal antibody drug attaches to the cancer cells then releases the chemotherapy drug directly into the cell.
How often will I receive Trodelvy ®?
For this treatment to be most effective, it is given at specific time intervals. It is usual to have Trodelvy ® once a week for 2 weeks then 1 week off. The exact number of treatments you will receive will be discussed with you.
How often will I see the specialist team?
We will let you know how often you will need to be reviewed by your specialist team. This will either be in the outpatient clinic or a telephone review. You will need a blood test before each treatment. At each visit or review we will check how you are feeling and discuss any problems you may have.
How is Trodelvy given?
Trodelvy is given through a drip into a vein in the back of your hand or arm. However, sometimes, if your veins are difficult to find, it may be suggested that a fine tube called a PICC is inserted into a large vein in your upper arm. This will remain in place throughout the course of your treatment. Your doctor or nurse will discuss this further with you, if required. We have a leaflet that tells you more about PICC lines. Please let your doctor or your nurse know if you have had previous problems with finding a vein.
Where will my treatment be given?
Your treatment will be in one of the day case treatment areas at Velindre.
How long will my appointment take?
Your first Trodelvy ® is given more slowly to ensure that you do not have any reaction to the treatment. You should allow approximately 5 - 6 hours for your first 2 treatments. If you did not have any problems during the first 2 treatments the next Trodelvy ® treatments will be given slightly quicker. The appointments will take approximately 4 – 5 hours.
Can I bring a relative with me?You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person. Treatment areas are not suitable for young children.
What are the possible side effects?
There are a number of possible side effects which can occur. We have included details of the most common side effects. Most side effects are short lived can be easily treated, but sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects. The telephone number is at the end of the leaflet.
Reactions during the treatment
Some patients may experience a reaction at the time the Trodelvy ® is given. This is why the first treatment is given more slowly. A nurse will monitor you closely during the treatment and for 30 minutes after it has finished.
If you experience any of the following during the treatment please tell your nurse straight away:
• Feeling hot and feverish
• Chills or shivering
• Dizziness or faintness
• Problems with breathing
• Rash or itching
• Feeling sick or vomiting
• Swelling of face/mouth ( this is rare)
• Pain in back, abdomen or chest
If any of these occur we will slow down or stop the Trodelvy® until you feel better. If needed, we will give you medication to help with the symptoms.
Sometimes patients can experience a reaction at home in the first 24 hours after the treatment. If you develop a red itchy rash or you are slightly short of breath you need to contact the treatment helpline immediately. Due to the newness of this treatment we do not have the information from the drug company of how often this happens. We will send you home with anti-histamine tablets to take if this happens. If you develop severe allergic reaction such as difficulty breathing, swelling to your tongue or lips you must seek urgent medical attention.
You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.
If you develop an infection whilst your white blood cells are low, you are at risk of sepsis, this can be life threatening.
Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade. The telephone number is at the end of the leaflet.
You can be sick following treatment with Trodelvy ®, we will give you anti-sickness medication before your treatment and some to take home. This should prevent you from being sick. If you are sick more than once in 24 hours or you feel so sick that you are not able to eat or drink ring the treatment helpline.
You will also be given an anti-sickness tablet to take approximately 1 hour before your treatment time.
Diarrhoea may occur with Trodelvy ®. We will give you some anti-diarrhoea medication to take home. After the first episode of diarrhoea you should start taking these following the instructions on the box. It is important that you drink plenty of water and salty type liquids if you have diarrhoea. These include soda water, carbonated water and soups.
If you have a raised temperature, experience shivering episodes, have stomach cramps or the diarrhoea continues for more than 12 hours, contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet
Tiredness and fatigue
You may feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as rest.
You may lose your hair with this treatment. This is temporary and your hair will grow back when you finish your treatment. We can arrange a wig if you would like one, please ask your nurse for more information.
We have a leaflet on coping with hair loss. Please ask your nurse if you would like a copy. A method known as ‘scalp cooling’ or ‘cold capping’ can sometimes be used to prevent hair loss please ask if you would like to know more.
You may have headaches with this treatment. It is important you drink plenty of fluids preferably water. You can take whatever pain killer you would usually take for a headache.
Your mouth may become sore or you may notice small ulcers. Please follow the advice on caring for your mouth in the general chemotherapy leaflet. Your doctor may prescribe mouthwashes or medication to prevent or clear any infection.
If your mouth has become so sore that it is making it difficult to eat or drink contact Velindre Cancer Centre. The telephone number is at the end of the leaflet
Anaemia and low platelets:
If you feel tired, short of breath or notice unusual bruising or bleeding, ring the treatment helpline for advice.
Skin and tissue damage
Some chemotherapy drugs may damage the skin and surrounding area if they leak outside of your vein. This is known as extravasation. It is extremely rare but it is important that you tell us immediately if you notice any swelling, pain or burning at the site of the drip. If this occurs whilst the chemotherapy is being given, tell your nurse. If you notice pain, swelling or redness when you’re at home please contact us immediately the telephone number is at the end of the leaflet
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Pregnancy and breast feeding
It is important you do not become pregnant whilst having Trodelvy ® treatment, and for 6 months after completing the treatment. Breastfeeding is not recommended during treatment and for a minimum of 1 months following completion of treatment. Men should use effective contraception during treatment and for a least 3 months after completing treatment.
Taking other medication with Trodelvy ®
Please ensure that you Velindre team are aware of medicines you are currently taking. Before starting any new medicines you should tell your doctor or pharmacist that you have had Trodelvy ®.
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
If you are unwell at home and need immediate advice at any time of the day or night ask for the treatment helpline
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Macmillan freephone Helpline 0808 808 0000
Tenovus freephone 0808 808 1010
This information is also available in Welsh
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. The leaflet has been approved by doctors, nurses, pharmacists and patients. It is reviewed and updated every 2 years.
Written November 2021