Interstitial pneumonitis related to sacituzumab govitecan in a patient with metastatic triple-negative breast cancer - case report

Sep 23, 2026

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Background Sacituzumab-govitecan-related pulmonary toxicity is rare. This case report describes a patient who developed sacituzumab govitecan-induced interstitial pneumonitis that responded to corticosteroids after discontinuation. Case presentation A 62-year-old Taiwanese woman with metastatic triple-negative breast cancer was refractory to prior chemotherapy lines and developed progressive dyspnea and dry cough after treatment. Imaging showed diffuse ground-glass opacities and interlobular septal thickening, leading to suspicion of grade 3 interstitial pneumonitis with a Naranjo score of 7. Symptoms and pulmonary infiltrations improved within one week. The drug was rechallenged at half dose and she completed four additional cycles without recurrent pneumonitis before disease progression.

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Lin and Lin Journal of Medical Case Reports (2026) 20:103 [https://doi.org/10.1186/s13256-025-05820-z](https://doi.org/10.1186/s13256-025-05820-z) Journal of Medical Case Reports CASE REPORT Open Access Interstitial pneumonitis related to sacituzumab govitecan in a patient with metastatic triple-negative breast cancer: a case report Meng-chan Lin 1 and Chun-wei Lin2,3* Abstract Background Sacituzumab-govitecan-related pulmonary toxicity is rare. Herein, we describe a case of sacituzumabgovitecan-induced interstitial pneumonitis that was successfully rechallenged with a reduced drug dose. Case presentation A 62-year-old Taiwanese female patient with metastatic triple-negative breast cancer was refractory to the previous four lines of chemotherapy. She was subsequently given therapy with sacituzumab govitecan (10 mg/kg) . After the second cycle, she developed progressive dyspnea, dry cough, and diarrhea. Chest computed tomography revealed diffuse ground grass opacity of the bilateral lungs with multiple foci of black area (reverse hall sign) and thickening of the interlobular septa. In the absence of other potential causes, sacituzumab-govitecaninduced grade 3 interstitial pneumonitis was strongly suspected, with a Naranjo score of 7. Sacituzumab govitecan discontinuation and corticosteroid therapy (prednisolone 2 mg/kg/day) were initiated. Her clinical symptoms and radiographic pulmonary infiltrations were significant improvement within 1 week. Sacituzumab govitecan was rechallenged in half dose due to lack of alternative treatment for the metastatic triple-negative breast cancer. She completed four additional cycles without recurrent pneumonitis before disease progression. The progression-free survival was 5.37 months. Conclusion Sacituzumab govitecan is a new generation of antibody–drug conjugates. Early detection of druginduced interstitial lung disease, drug discontinuation ,and immediate steroid therapy are important. Permanent antibody–drug conjugates discontinuation is advised for patients with grade ≥ 2 drug-induced interstitial lung disease. In this case, due to the limited treatment for metastatic triple-negative breast cancer, the patient was rechallenged with half dose of sacituzumab govitecan without recurrent pneumonitis. Keywords Interstitial pneumonitis, Interstitial lung disease, Breast cancer, Sacituzumab govitecan, Antibody–drug conjugates, Case report *Correspondence: Chun-wei Lin [skimylin@gmail.com](skimylin@gmail.com) 1 Department of Psychiatry, National Cheng Kung University Hospital, Tainan city 70403, Taiwan 2 Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, 135, Nanxiao St., Changhua City 50006, Taiwan 3 Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung 40227, Taiwan Introduction Human trophoblast cell-surface antigen 2 (Trop-2), a transmembrane glycoprotein, is more abundantly expressed in solid epithelial carcinoma than in normal tissue [1]. Trop-2 overexpression has been reported to induce cancer growth, proliferation, and metastasis [2]. Sacituzumab govitecan (SG) is an antibody–drug conjugate (ADC) composed of an antibody targeting Trop-2 © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the

FAQs

How was sacituzumab govitecan-induced interstitial pneumonitis suspected in the case?

After the patient developed progressive dyspnea, dry cough, and diarrhea, chest CT showed diffuse ground-glass opacities and interlobular septal thickening. With other causes absent, clinicians strongly suspected grade 3 interstitial pneumonitis and calculated a Naranjo score of 7.

What treatment led to improvement in symptoms and lung findings?

Sacituzumab govitecan was discontinued and corticosteroid therapy with prednisolone 2 mg/kg/day was initiated. Clinical symptoms and radiographic pulmonary infiltrations improved within one week.

Was sacituzumab govitecan restarted after the pneumonitis episode?

Yes. Because of limited alternative options, the patient was rechallenged with half-dose sacituzumab govitecan and completed four additional cycles without recurrent pneumonitis before later disease progression.

Sep 23, 2026

Uploaded by Oliver