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SN-38

Generic Name
SN-38
Brand Names
Trodelvy
Drug Type
Small Molecule
Chemical Formula
C22H20N2O5
CAS Number
86639-52-3
Unique Ingredient Identifier
0H43101T0J

Overview

7-ethyl-10-hydroxycamptothecin (SN 38) is a liposomal formulation of the active metabolite of Irinotecan Irinotecan, a chemotherapeutic pro-drug approved for the treatment of advanced colorectal cancer. SN 38 has been used in trials studying the treatment of Cancer, Advanced Solid Tumors, Small Cell Lung Cancer, Metastatic Colorectal Cancer, and Triple Negative Breast Cancer, among others.

Indication

Investigated for use/treatment in colorectal cancer.

Associated Conditions

  • Hormone Receptor Positive Metastatic Breast Cancer
  • Locally Advanced or Metastatic Urothelial Carcinoma (UC)
  • Metastatic Triple Negative Breast Cancers
  • Unresectable Triple-Negative Breast Carcinoma
  • Metastatic HR Positive, HER2/Neu Negative Breast Cancer
  • Unresectable Locally Advanced Triple-negative Breast Cancer
  • Unresectable, locally advanced HR Positive, HER2/Neu Negative Breast Cancer
  • Unresectable, locally advanced Hormone Receptor Positive Breast Carcinoma

Research Report

Published: Aug 1, 2025

SN-38: A Comprehensive Monograph on a Pivotal Topoisomerase I Inhibitor—From Prodrug Metabolite to Advanced Therapeutic Payload

1.0 Introduction: The Re-emergence of a Potent Camptothecin Analog

The history of oncology is marked by the discovery of natural products with profound cytotoxic activity, whose clinical potential was initially hindered by challenging pharmaceutical properties. Few molecules exemplify this narrative better than SN-38 (7-ethyl-10-hydroxycamptothecin). As a semi-synthetic analog of camptothecin, SN-38 belongs to a class of agents that revolutionized cancer treatment by identifying a novel molecular target: DNA topoisomerase I.[1] However, SN-38 is most widely known not as a drug administered to patients, but as the principal active metabolite of irinotecan (CPT-11), a cornerstone chemotherapeutic agent used in the treatment of various solid tumors, most notably metastatic colorectal cancer.[3] The entire therapeutic rationale for administering the water-soluble prodrug irinotecan is to facilitate the

in vivo generation of SN-38, the molecule responsible for virtually all of the desired antitumor effect.[6]

Continue reading the full research report

Clinical Trials

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Title
Posted
Study ID
Phase
Status
Sponsor
A Study of Sacituzumab Govitecan (IMMU-132) in Platinum-resistant Ovarian Cancer Patients
2023/09/08
NCT06028932
Phase 2
Active, not recruiting
Yale University
Phase II Trial of Sacituzumab Govitecan in Recurrent and/or Metastatic Secretory Gland Cancers
2023/06/01
NCT05884320
Phase 2
Recruiting
M.D. Anderson Cancer Center
A Phase 1/2, First-in-Human Study to Assess the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Anti_Tumor Activity of AVZO-021 as a Single Agent and in Combination Therapy in Patients with Advanced Solid Tumors.
2023/05/19
2024-517339-30-00
Phase 1/2
Recruiting
Avenzo Therapeutics Inc.
Study of Sacituzumab Govitecan Versus Treatment of Physician's Choice in Patients With Hormone Receptor-positive/Human Epidermal Growth Factor Receptor 2 Negative (HR+/HER2-) Metastatic Breast Cancer Who Have Received Endocrine Therapy
2023/05/03
NCT05840211
Phase 3
Active, not recruiting
Gilead Sciences
A Study of Sacituzumab Govitecan (IMMU-132) in Patients With Recurrent or Persistent Cervical Cancer
2023/05/01
NCT05838521
Phase 2
Recruiting
Yale University
Adaptive RADiation Therapy with Concurrent Sacituzumab Govitecan (SG) for Muscle Invasive Bladder Cancer
2023/04/27
NCT05833867
Phase 1
Recruiting
Shilpa Gupta, MD
Circulating Tumor DNA to Guide Changes in Standard of Care Chemotherapy
2023/03/15
NCT05770531
Phase 2
Recruiting
Vanderbilt-Ingram Cancer Center
A Phase II Study of Neoadjuvant Sacituzumab Govitecan and Pembrolizumab Therapy for Immunochemotherapy-resistant Early-stage Triple-negative Breast Cancer (TNBC)
2023/01/09
NCT05675579
Phase 2
Recruiting
M.D. Anderson Cancer Center
Study of Pembrolizumab (MK-3475) Monotherapy Versus Sacituzumab Govitecan in Combination With Pembrolizumab for Participants With Metastatic Non-small Cell Lung Cancer (NSCLC) With Programmed Cell Death Ligand 1 (PD-L1) Tumor Proportion Score (TPS) ≥50% (MK-3475-D46)
2022/11/08
NCT05609968
Phase 3
Recruiting
Merck Sharp & Dohme LLC
Sacituzumab Govitecan Before Radical Cystectomy for the Treatment of Non-Urothelial Muscle Invasive Bladder Cancer
2022/10/14
NCT05581589
Phase 2
Recruiting
University of Washington

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