This study presents a multi-center, retrospective analysis of the safety and efficacy of sacituzumab govitecan in patients with advanced triple-negative breast cancer (mTNBC) in Italy. The objective was to evaluate the drug's safety and effectiveness in real-world clinical practice. Data from 57 patients who received sacituzumab govitecan for mTNBC were analyzed. The median age was 53 years, with approximately 70% of patients having an initial diagnosis of TNBC. The median time from diagnosis of metastatic breast cancer to the start of treatment was 17 months, and the median number of previous therapies was 3. The most common sites of metastasis were lymph nodes, lung, bone, and liver. The median progression-free survival (PFS) was 4.9 months, and the median overall survival (OS) was 12.4 months. The most common treatment-related adverse events (AEs) were anemia, alopecia, neutropenia, nausea, and diarrhea. Neutropenia was the most common serious AE. A total of 32 patients died during the study, with 22 patients reducing the dose and 3 patients permanently discontinuing treatment. The results of this real-world analysis showed that the safety and efficacy of sacituzumab govitecan in mTNBC patients are consistent with those previously reported in regulatory trials. The use of premedication and supportive measures was associated with a satisfactory toxicity profile. The study highlights the importance of managing toxicities to optimize patient care and treatment adherence. The findings suggest that sacituzumab govitecan is a safe and effective treatment option for mTNBC patients in real-world settings.This study presents a multi-center, retrospective analysis of the safety and efficacy of sacituzumab govitecan in patients with advanced triple-negative breast cancer (mTNBC) in Italy. The objective was to evaluate the drug's safety and effectiveness in real-world clinical practice. Data from 57 patients who received sacituzumab govitecan for mTNBC were analyzed. The median age was 53 years, with approximately 70% of patients having an initial diagnosis of TNBC. The median time from diagnosis of metastatic breast cancer to the start of treatment was 17 months, and the median number of previous therapies was 3. The most common sites of metastasis were lymph nodes, lung, bone, and liver. The median progression-free survival (PFS) was 4.9 months, and the median overall survival (OS) was 12.4 months. The most common treatment-related adverse events (AEs) were anemia, alopecia, neutropenia, nausea, and diarrhea. Neutropenia was the most common serious AE. A total of 32 patients died during the study, with 22 patients reducing the dose and 3 patients permanently discontinuing treatment. The results of this real-world analysis showed that the safety and efficacy of sacituzumab govitecan in mTNBC patients are consistent with those previously reported in regulatory trials. The use of premedication and supportive measures was associated with a satisfactory toxicity profile. The study highlights the importance of managing toxicities to optimize patient care and treatment adherence. The findings suggest that sacituzumab govitecan is a safe and effective treatment option for mTNBC patients in real-world settings.