Additionally, the guidelines now include the combination of sacituzumab govitecan and the PD-1 inhibitor pembrolizumab (Keytruda) as a Category 2A preferred option for first-line metastatic TNBC in patients with PD-L1-positive tumors (CPS ≥10). While the NCCN has integrated these regimens into its clinical guidelines, the use of sacituzumab govitecan in the first-line setting remains investigational. Trodelvy® added as preferred regimen within first-line metastatic triple-negative breast cancer in NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Breast Cancer. Sacituzumab govitecan (SG) + pembrolizumab (pembro) vs chemotherapy (chemo) + pembro in previously untreated PD-L1–positive advanced triple-negative breast cancer (TNBC): Primary results from the randomized phase 3 ASCENT-04/KEYNOTE-D19 study.