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Beqalzi: which tox species, and why?

sonrotoclax · BCL-2
Species
Mouse and dog
“The GLP-compliant repeat-dose toxicology studies of up to 13 weeks of dosing were conducted in mice and dogs with animals dosed daily via oral gavage.”
✓ VerifiedFDA multi-discipline review, p. 26Source ↗
Why that species
Pharmacologically relevant: high BCL2 sequence homology, comparable in vitro metabolism, adequate bioavailability
“Mice and dogs were pharmacologically relevant species for toxicity evaluation, based on their high BCL2 sequence homology with humans, comparable metabolism profiles with humans in in vitro studies, and adequate bioavailability.”
✓ VerifiedFDA multi-discipline review, p. 35Source ↗
Surrogate molecule
No surrogate; the clinical compound was tested
“In the 13-week dog study, sonrotoclax was administered at doses of 10, 30, or 100 mg/kg/day.”
✓ VerifiedFDA multi-discipline review, p. 27Source ↗

Same question, other small molecules

Accrufer

ferric maltol · Iron replacement
Dog

Adquey

difamilast · PDE4 (topical)
Rat, dog and minipig

Agamree

vamorolone · Glucocorticoid receptor (dissociative)
Mouse and dog

Alyftrek

vanzacaftor, tezacaftor and deutivacaftor · CFTR
Rat and dog

Anzupgo

delgocitinib · Pan-JAK (topical)
Rat and dog (oral); minipig and mouse (dermal)

Aqneursa

levacetylleucine · Neuronal metabolism (proposed)
Rat and dog

Artesunate

artesunate · Plasmodium (antimalarial)
Rat and dog

Attruby

acoramidis · Transthyretin (stabiliser)
Rat and dog

Augtyro

repotrectinib · ROS1/TRK
Rat and cynomolgus monkey

Avmapki Fakzynja Co-pack

avutometinib and defactinib · RAF/MEK clamp; FAK
Rat and monkey (avutometinib); rat and dog (defactinib)

Ayvakit

avapritinib · KIT/PDGFRA
Rat and dog

Azstarys

serdexmethylphenidate and dexmethylphenidate · Dopamine/norepinephrine reuptake
Rat and dog (28-day); rabbit (6-month juvenile, EFD)

Balversa

erdafitinib · FGFR1-4
Rat and dog

Barhemsys

amisulpride · Dopamine D2/D3 receptor
Rat

Baxfendy

baxdrostat · Aldosterone synthase (CYP11B2)
Rat and cynomolgus monkey

Blujepa

gepotidacin · Bacterial topoisomerases (gyrase/topo IV)
Rat and dog

Brenzavvy

bexagliflozin · SGLT2
Rat and monkey

Brexafemme

ibrexafungerp · Fungal glucan synthase
Rat and dog

Brinsupri

brensocatib · DPP1 (cathepsin C)
Rat and dog

Byfavo

remimazolam · GABA-A receptor (benzodiazepine site)
Cynomolgus monkey and minipig

Bylvay

odevixibat · IBAT
Rat and dog

Cabenuva

cabotegravir and rilpivirine · HIV-1 integrase; NNRTI
Rat and monkey (cabotegravir)

Camzyos

mavacamten · Cardiac myosin
Rat and dog

Caplyta

lumateperone · 5-HT2A / D2 receptor
Rat and dog (mouse up to 3 months)

Cardamyst

etripamil · L-type calcium channel
Rat and cynomolgus monkey

Cibinqo

abrocitinib · JAK1
Rat and cynomolgus monkey

Cobenfy

xanomeline and trospium · Muscarinic M1/M4 agonist; peripheral antagonist
Rat and monkey

Cosela

trilaciclib · CDK4/6
Rat and dog

Crenessity

crinecerfont · CRF1 receptor
Rat and dog

Cypsedo

cipepofol · GABA-A receptor
Rat and dog

Daybue

trofinetide · IGF-1 tripeptide analogue
Rat and dog

Dayvigo

lemborexant · Orexin OX1/OX2 receptors
Rat and monkey

Defencath

taurolidine and heparin · Antimicrobial catheter lock
Rat (14-day IV study) and mouse (single-dose IP study)

Dojolvi

triheptanoin · Anaplerotic energy substrate
Minipig (GLP); published rat dietary study

Duvyzat

givinostat · Histone deacetylase (class I/II)
Rat and monkey (supporting 13-week mouse and 4-week dog)

Egaten

triclabendazole · Fasciola (tubulin)
Rat and dog

Ekterly

sebetralstat · Plasma kallikrein
Rat and cynomolgus monkey

Evrysdi

risdiplam · SMN2 splicing
Rat and cynomolgus monkey

Exblifep

cefepime and enmetazobactam · PBPs; beta-lactamase (enmetazobactam)
Rat and dog

Exkivity

mobocertinib · EGFR exon 20 insertion
Rat and dog

Exxua

gepirone · 5-HT1A receptor
Rat and dog

Fabhalta

iptacopan · Complement factor B
Rat and dog

Fetroja

cefiderocol · Penicillin-binding proteins
Rat and monkey

Filspari

sparsentan · Endothelin A / angiotensin II receptors
Mouse, rat and cynomolgus monkey

Fotivda

tivozanib · VEGFR1-3
Rat and cynomolgus monkey

Foundayo

orforglipron · GLP-1 receptor (non-peptide)
Rat and cynomolgus monkey

Fruzaqla

fruquintinib · VEGFR1-3
Rat and dog

Gavreto

pralsetinib · RET
Rat and cynomolgus monkey

Gemtesa

vibegron · β3-adrenergic receptor
Rat and cynomolgus monkey

Gomekli

mirdametinib · MEK1/2
Rat and dog

Grafapex

treosulfan · DNA alkylation
Rat, dog and monkey

Hernexeos

zongertinib · HER2 (mutant)
Rat and dog

Hyrnuo

sevabertinib · HER2 (mutant)
Rat and monkey

Ibsrela

tenapanor · NHE3
Rat and dog

Ibtrozi

taletrectinib · ROS1
Rat and cynomolgus monkey

Idvynso

doravirine and islatravir · NNRTI; NRTTI
Rat and rhesus monkey (islatravir), plus mouse up to 3 months

Inluriyo

imlunestrant · Estrogen receptor (SERD)
Rat and cynomolgus monkey

Inpefa

sotagliflozin · SGLT1/SGLT2
Rat and dog

Inqovi

decitabine and cedazuridine · DNMT (decitabine); cytidine deaminase (cedazuridine)
Mouse and cynomolgus monkey (cedazuridine); rat (decitabine)

Inrebic

fedratinib · JAK2
Rat and dog

Iqirvo

elafibranor · PPARα/δ
Rat and cynomolgus monkey (mouse up to 3 months)

Isturisa

osilodrostat · 11β-hydroxylase (CYP11B1)
Rat and dog

Itovebi

inavolisib · PI3Kα (mutant-selective)
Rat and dog

Jascayd

nerandomilast · PDE4B
Rat, minipig and cynomolgus monkey

Jaypirca

pirtobrutinib · BTK (non-covalent)
Rat and dog

Jesduvroq

daprodustat · HIF prolyl hydroxylase
Rat and cynomolgus monkey (dog in studies up to 13 weeks)

Joenja

leniolisib · PI3Kδ
Rat and cynomolgus monkey

Journavx

suzetrigine · NaV1.8
Rat and cynomolgus monkey

Kerendia

finerenone · Mineralocorticoid receptor
Rat and dog

Klisyri

tirbanibulin · Tubulin / Src
Rat and dog (oral); minipig and rat (topical)

Komzifti

ziftomenib · Menin-KMT2A
Mouse and dog

Koselugo

selumetinib · MEK1/2
Mouse, rat and cynomolgus monkey

Krazati

adagrasib · KRAS G12C
Rat and dog

Kygevvi

doxecitine and doxribtimine · Pyrimidine nucleoside replacement (TK2 deficiency)
Rat and dog (plus 4-week mouse)

Lampit

nifurtimox · Trypanosoma cruzi
Rat and dog

Lazcluze

lazertinib · EGFR (mutant-selective)
Rat and dog

Leqselvi

deuruxolitinib · JAK1/JAK2
Rat and dog

Lifyorli

relacorilant · Glucocorticoid receptor (antagonist)
Rat and cynomolgus monkey

Litfulo

ritlecitinib · JAK3/TEC kinases
Rat and dog

Livdelzi

seladelpar · PPARδ
Rat and cynomolgus monkey (also mouse and dog)

Livmarli

maralixibat · IBAT (ASBT)
Rat and dog

Livtencity

maribavir · CMV UL97 protein kinase
Rat and cynomolgus monkey (plus 13-week mouse)

Lumakras

sotorasib · KRAS G12C
Rat and dog

Lupkynis

voclosporin · Calcineurin
Rat and cynomolgus monkey

Lybalvi

olanzapine and samidorphan · D2/5-HT2A; opioid receptors (samidorphan)
Rat and dog

Lynavoy

linerixibat · IBAT
Rat and dog

Lynkuet

elinzanetant · NK1/NK3 receptors
Rat and cynomolgus monkey

Lytgobi

futibatinib · FGFR1-4 (covalent)
Rat and dog

Mayzent

siponimod · S1P1/S1P5 receptor
Rat and cynomolgus monkey

Miebo

perfluorohexyloctane · Tear film evaporation barrier
Rabbit (ocular) and rat (oral)

Miplyffa

arimoclomol · Heat-shock response amplifier
Rat and dog

Modeyso

dordaviprone · DRD2 antagonist / ClpP agonist
Rat and dog

Myqorzo

aficamten · Cardiac myosin
Rat and dog

Nereus

tradipitant · NK1 receptor
Rat and dog (plus 13-week mouse)

Nexletol

bempedoic acid · ATP citrate lyase
Rat and monkey

Nextstellis

drospirenone and estetrol · Estrogen / progestin receptors
Rat and cynomolgus monkey

Nourianz

istradefylline · Adenosine A2A receptor
Rat and dog

Nubeqa

darolutamide · Androgen receptor
Rat and dog

Nulibry

fosdenopterin · cPMP replacement (MoCD type A)
Rat and dog (juvenile)

Nurtec ODT

rimegepant · CGRP receptor
Rat and cynomolgus monkey

Nuzolvence

zoliflodacin · Bacterial topoisomerase II
Rat and dog

Ogsiveo

nirogacestat · Gamma secretase
Rat and dog

Ohtuvayre

ensifentrine · PDE3/PDE4
Rat and dog

Ojemda

tovorafenib · RAF (type II pan-RAF)
Rat and cynomolgus monkey

Ojjaara

momelotinib · JAK1/JAK2/ACVR1
Rat and dog

Olinvyk

oliceridine · μ-opioid receptor (G-protein biased)
Rat and monkey

Omlonti

omidenepag isopropyl · EP2 receptor
Rat and cynomolgus monkey

Ongentys

opicapone · COMT
Rat and cynomolgus monkey

Orgovyx

relugolix · GnRH receptor
Rat and cynomolgus monkey (mouse up to 13 weeks)

Orladeyo

berotralstat · Plasma kallikrein
Rat and monkey

Orlynvah

sulopenem etzadroxil and probenecid · Penicillin-binding proteins
Rat and cynomolgus monkey

Orserdu

elacestrant · Estrogen receptor (SERD)
Rat and cynomolgus monkey

Orzeyful

oveporexton · Orexin OX2 receptor agonist
Rat and cynomolgus monkey

Oxbryta

voxelotor · HbS polymerisation
Rat and cynomolgus monkey (also mouse)

Palsonify

paltusotine · Somatostatin receptor 2
Rat and dog

Paxlovid

nirmatrelvir and ritonavir · SARS-CoV-2 Mpro (3CL protease)
Rat and cynomolgus monkey

Pemazyre

pemigatinib · FGFR1-3
Rat and cynomolgus monkey

Piqray

alpelisib · PI3Kα
Rat and dog

Pizensy

lactitol · Osmotic laxative
Rat and Tg.rasH2 mouse

Ponvory

ponesimod · S1P1 receptor
Rat and dog (mouse for carcinogenicity, rabbit for EFD)

Pretomanid

pretomanid · Mycobacterial cell wall / respiration
Rat and cynomolgus monkey

Pyrukynd

mitapivat · Pyruvate kinase (activator)
Rat and cynomolgus monkey

Qelbree

viloxazine · Norepinephrine reuptake
Rat and dog

Qinlock

ripretinib · KIT/PDGFRA
Rat and dog

Qulipta

atogepant · CGRP receptor
Rat and rhesus monkey

Quviviq

daridorexant · Orexin OX1/OX2 receptors
Rat and dog

Rapiblyk

landiolol · β1-adrenergic receptor
Rat and dog

Rasonque

daraxonrasib · RAS(ON) multi-selective
Mouse and cynomolgus monkey

Recarbrio

imipenem, cilastatin and relebactam · Beta-lactamase (relebactam)
Rat and monkey

Relyvrio

sodium phenylbutyrate and taurursodiol · ER stress / mitochondrial (proposed)
Rat and minipig

Retevmo

selpercatinib · RET
Rat and Göttingen minipig

Revuforj

revumenib · Menin-KMT2A
Rat and dog

Reyvow

lasmiditan · 5-HT1F receptor
Rat and dog

Rezdiffra

resmetirom · Thyroid hormone receptor β
Rat and dog (plus mouse up to 3 months)

Rezlidhia

olutasidenib · IDH1 (mutant)
Rat and cynomolgus monkey

Rezzayo

rezafungin · Fungal glucan synthase
Rat and cynomolgus monkey

Rinvoq

upadacitinib · JAK1
Rat and dog

Rozlytrek

entrectinib · TRK/ROS1/ALK
Rat and dog

Rukobia

fostemsavir · HIV-1 gp120 (attachment)
Rat and dog

Scemblix

asciminib · BCR-ABL1 (STAMP, myristoyl pocket)
Rat and cynomolgus monkey (plus 4-week dog)

Sephience

sepiapterin · Tetrahydrobiopterin precursor
Rat and marmoset monkey

Simtriyo

centanafadine · Triple monoamine reuptake
Rat and dog

Skyclarys

omaveloxolone · Nrf2 activator
Rat and cynomolgus monkey

Sofdra

sofpironium · Muscarinic receptors (topical)
Rat and Göttingen minipig

Sohonos

palovarotene · RARγ
Rat and dog

Sotyktu

deucravacitinib · TYK2
Rat and cynomolgus monkey

Sunlenca

lenacapavir · HIV-1 capsid
Rat and dog

Sunosi

solriamfetol · Dopamine/norepinephrine reuptake
Rat and dog (plus 3-month mouse)

Tabrecta

capmatinib · MET
Rat and cynomolgus monkey

Tavneos

avacopan · C5a receptor (C5aR1)
Hamster, rat and cynomolgus monkey

Tazverik

tazemetostat · EZH2
Rat and cynomolgus monkey

Trikafta

elexacaftor, tezacaftor and ivacaftor · CFTR
Rat and dog

Truqap

capivasertib · AKT1-3
Rat and dog

Tryptyr

acoltremon · TRPM8 agonist
Rabbit and dog (ocular); rat (intravenous)

Tryvio

aprocitentan · Endothelin A/B receptors
Rat and dog

Tukysa

tucatinib · HER2
Rat and cynomolgus monkey

Turalio

pexidartinib · CSF1R
Rat and dog

Ubrelvy

ubrogepant · CGRP receptor
Rat and rhesus monkey

Ukoniq

umbralisib · PI3Kδ / CK1ε
Mouse and dog

Utebzi

tebipenem pivoxil · Penicillin-binding proteins
Rat and cynomolgus monkey

Vafseo

vadadustat · HIF prolyl hydroxylase
Rat and dog (plus 3-month mouse)

Vanflyta

quizartinib · FLT3
Rat, dog and cynomolgus monkey

Vanrafia

atrasentan · Endothelin A receptor
Rat and dog

Veklury

remdesivir · SARS-CoV-2 RNA polymerase
Rat and cynomolgus monkey

Velsipity

etrasimod · S1P1/S1P4/S1P5 receptors
Rat and dog

Veozah

fezolinetant · Neurokinin-3 receptor
Rat and cynomolgus monkey (females)

Veppanu

vepdegestrant · Estrogen receptor (PROTAC degrader)
Rat and dog

Verquvo

vericiguat · Soluble guanylate cyclase
Rat and dog

Vivjoa

oteseconazole · Fungal CYP51
Rat and dog

Vizz

aceclidine · Muscarinic agonist (miotic)
Rabbit

Vonjo

pacritinib · JAK2/FLT3
Mouse and dog

Voquezna

vonoprazan · H+/K+-ATPase (potassium-competitive)
Rat and dog

Voranigo

vorasidenib · IDH1/IDH2
Rat and cynomolgus monkey

Voydeya

danicopan · Complement factor D
Rat and dog

Vtama

tapinarof · Aryl hydrocarbon receptor
Rat and minipig

Vyndaqel

tafamidis · Transthyretin (stabiliser)
Rat and dog

Wakix

pitolisant · Histamine H3 receptor
Rat and cynomolgus monkey (mouse up to 1 month)

Wayrilz

rilzabrutinib · BTK (reversible covalent)
Rat and dog

Welireg

belzutifan · HIF-2α
Rat and dog

Winlevi

clascoterone · Androgen receptor (topical)
Rat and minipig

Xacduro

sulbactam and durlobactam · PBPs; beta-lactamase (durlobactam)
Rat and dog (mouse for embryo-fetal development)

Xcopri

cenobamate · Sodium channel / GABA-A
Rat and cynomolgus monkey (mouse up to 13 weeks)

Xdemvy

lotilaner · Mite GABA-Cl channel
Rabbit and dog (ocular); rat and dog (systemic)

Xeglyze

abametapir · Lice metalloproteinases
Rat and minipig

Xenleta

lefamulin · Bacterial ribosome (50S PTC)
Rat and cynomolgus monkey

Xocova

ensitrelvir · SARS-CoV-2 3CL protease
Rat and cynomolgus monkey

Xpovio

selinexor · XPO1
Rat and cynomolgus monkey

Zavzpret

zavegepant · CGRP receptor
Rat and cynomolgus monkey

Zaynich

cefepime and zidebactam · PBPs; beta-lactam enhancer (zidebactam)
Rat and dog

Zegfrovy

sunvozertinib · EGFR exon 20 insertion
Rat and dog

Zenbexus

iberdomide · Cereblon (CELMoD)
Rat and monkey

Zeposia

ozanimod · S1P1/S1P5 receptor
Rat and cynomolgus monkey

Zepzelca

lurbinectedin · DNA minor groove (transcription)
Rat, dog and cynomolgus monkey

Zevtera

ceftobiprole medocaril · Penicillin-binding proteins
Rat, marmoset and dog

Zokinvy

lonafarnib · Farnesyltransferase
Rat and cynomolgus monkey

Ztalmy

ganaxolone · GABA-A receptor (positive modulator)
Rat and dog

Zulresso

brexanolone · GABA-A receptor (positive modulator)
Rat and dog

Zurzuvae

zuranolone · GABA-A receptor (positive modulator)
Rat and dog

Zycubo

copper histidinate · Copper replacement (Menkes disease)
Juvenile rat only

Summary across all 211 small molecules →