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

zenocutuzumab · HER2 x HER3
Genotoxicity
Not conducted (ICH S6(R1))
“Standard genotoxicity studies are not considered appropriate for this class of biological product, in line with the ICH S6 (R1) guideline.”
✓ VerifiedFDA multi-discipline review, p. 85Source ↗
Carcinogenicity
Not conducted (ICH S6(R1), ICH S9)
“Carcinogenicity studies have not been performed with MCLA-128 as they are not considered appropriate for this class of biological product, in line with the ICH S6 (R1) and ICH S9 guidelines.”
✓ VerifiedFDA multi-discipline review, p. 85Source ↗
Reproductive & developmental
Not conducted; literature weight-of-evidence (HER2/HER3 essential for embryo-fetal development); boxed warning
“The Applicant did not conduct reproductive or embryo-fetal developmental toxicology studies with zenocutuzumab.”
✓ VerifiedFDA multi-discipline review, p. 58Source ↗
Safety pharmacology
Incorporated into repeat-dose monkey studies (ECG, BP, respiration, temperature, CNS); no effects
“Stand-alone safety pharmacology studies were not conducted. Safety pharmacology was evaluated as part of the general toxicology studies performed with MCLA-128.”
✓ VerifiedFDA multi-discipline review, p. 71Source ↗

Same question, other bispecifics

Blincyto

blinatumomab · CD19 x CD3
Not conducted (ICH S6(R1); protein of natural amino acids)

Columvi

glofitamab · CD20 x CD3
Not conducted (ICH S6(R1))

Elrexfio

elranatamab · BCMA x CD3
Not conducted (ICH S6(R1))

Epkinly

epcoritamab · CD20 x CD3
Not conducted (ICH S6(R1), ICH S9)

Hemlibra

emicizumab · FIXa x FX
Not conducted (ICH S6)

Imdelltra

tarlatamab · DLL3 x CD3
Not conducted (ICH S6(R1))

Kimmtrak

tebentafusp · CD3 x gp100 (TCR fusion)
Not conducted (fusion protein; ICH S6/S9)

Korjuny

catumaxomab · EpCAM x CD3
Not conducted (ICH S6(R1))

Lunsumio

mosunetuzumab · CD20 x CD3
Not conducted (ICH S6(R1))

Lynozyfic

linvoseltamab · BCMA x CD3
Not conducted (antibody not expected to interact with DNA)

Ordspono

odronextamab · CD20 x CD3
Not conducted (antibody not expected to interact with DNA)

Removab

catumaxomab · EpCAM x CD3
Not conducted (not submitted; biologic, no relevant model)

Rybrevant

amivantamab · EGFR x MET
Not conducted (not appropriate for antibodies)

Talvey

talquetamab · GPRC5D x CD3
Not conducted (ICH S6; biotechnology-derived product)

Tecvayli

teclistamab · BCMA x CD3
Not conducted (ICH S6(R1))

Vabysmo

faricimab · VEGF-A x Ang-2
Not conducted (ICH S6(R1))

Ziihera

zanidatamab · HER2 x HER2 (biparatopic)
Not conducted (ICH S6(R1), ICH S9)

Summary across all 18 bispecifics →