Request an invite

Besponsa: genotox, carcinogenicity and repro: done or skipped?

inotuzumab ozogamicin · CD22
Genotoxicity
Conducted: calicheamicin positive in Ames and in vitro micronucleus; ADC clastogenic in mouse micronucleus
“Inotuzumab ozogamicin was clastogenic in mice at doses ≥28 µg/kg (approximately 1.1 mg/m2 of the ADC), consistent with the known DNA-reactive activity of the calicheamicin payload.”
✓ VerifiedFDA multi-discipline review, p. 36Source ↗
Carcinogenicity
Not conducted (ICH S9); liver adenomas and preneoplastic changes in 6-month rat study
“No carcinogenicity studies were conducted or required to support a marketing application for the current indication.”
✓ VerifiedFDA multi-discipline review, p. 36Source ↗
Reproductive & developmental
Rat fertility and rat/rabbit EFD conducted: rat embryo-fetal toxicity (resorptions, low fetal weight); no PPND (ICH S9)
“Embryo-fetal development studies were conducted in rabbits and rats.”
✓ VerifiedFDA multi-discipline review, p. 35Source ↗
Safety pharmacology
Dedicated studies: CV in cynomolgus (transient BP effect), CNS and respiratory in rats
“A cardiovascular (CV) safety pharmacology study with inotuzumab ozogamicin in cynomolgus monkeys identified a small and transient effect on arterial blood pressure; the toxicological significance of this finding is unclear.”
✓ VerifiedFDA multi-discipline review, p. 34Source ↗

Same question, other ADCs

Adcetris

brentuximab vedotin · CD30
Conducted on MMAE: Ames and mouse lymphoma negative; rat micronucleus positive (aneugenic)

Datroway

datopotamab deruxtecan · Trop-2
Not conducted with ADC; DXd Ames negative, clastogenic in vitro chromosome aberration and in vivo rat micronucleus

Decnupaz

pivekimab sunirine · CD123
Not conducted with ADC (ICH S9); FGN849 positive in Ames TA102, in vitro and in vivo micronucleus

Elahere

mirvetuximab soravtansine · FRα
Not conducted with ADC; DM4 and S-methyl-DM4 Ames negative, rat bone marrow micronucleus positive

Emrelis

telisotuzumab vedotin · c-Met
Not conducted with ADC; MMAE aneugenic (positive rat micronucleus), Ames and mouse lymphoma negative

Enhertu

fam-trastuzumab deruxtecan · HER2
Not conducted with ADC; DXd clastogenic (rat micronucleus, CHL chromosome aberration), Ames negative

Kadcyla

ado-trastuzumab emtansine · HER2
Conducted on DM1: Ames negative; rat micronucleus positive (aneugenic/clastogenic); monkey micronucleus inconclusive

Mylotarg

gemtuzumab ozogamicin · CD33
Conducted: ADC clastogenic in mouse micronucleus; free calicheamicin DMH mutagenic and clastogenic in vitro

Padcev

enfortumab vedotin · Nectin-4
Not conducted with ADC; MMAE Ames and mouse lymphoma negative, rat micronucleus positive (aneugenic)

Polivy

polatuzumab vedotin · CD79b
Not conducted with ADC; MMAE Ames and mouse lymphoma negative, rat micronucleus positive (aneugenic)

Tivdak

tisotumab vedotin · Tissue factor
Not conducted with ADC; MMAE: Ames and mouse lymphoma negative, rat micronucleus positive (aneugenic)

Trodelvy

sacituzumab govitecan · Trop-2
Not conducted with ADC; SN-38 Ames negative, in vitro micronucleus positive (clastogenic)

Zynlonta

loncastuximab tesirine · CD19
Not conducted with ADC; SG3199 clastogenic in vitro (micronucleus, chromosome aberration); Ames not assessable (cytotoxicity)

Summary across all 14 ADCs →