Adcetris
brentuximab vedotin · CD30Monkey NOAEL serum exposure ~2 to 3x human exposure at the clinical dose
Enhertu: what safety margin did regulators accept?
fam-trastuzumab deruxtecan · HER2
Safety margin at NOAEL
Monkey 30 mg/kg (3-month study) ≥7x human AUC at 5.4 mg/kg
“In a three-month repeat-dose toxicity study in monkeys, intravenous administration of DS-8201a decreased numbers of round spermatids in the testes at seminiferous tubule stages V to VI at doses ≥ 30 mg/kg (≥ 7 times the exposure at the human recommended dose of 5.4 mg/kg based on AUC).”
NOAEL / key findings
HNSTD 30 mg/kg monkey, 197 mg/kg rat; bone marrow, intestine, skin, lung, testis, kidney; lung toxicity at 78.8 mg/kg
“The highest non-severely toxic dose of trastuzumab deruxtecan was established at 197 mg/kg in rats (non-binding species), and 30 mg/kg in cynomolgus monkey”
Same question, other ADCs
Besponsa
inotuzumab ozogamicin · CD22No NOAEL for rat male reproductive effects, seen at ~0.3x human AUC
Datroway
datopotamab deruxtecan · Trop-2Monkey NOAEL 10 mg/kg (lung, cornea, skin, liver, thymus): margin of exposure 0.25 (below human exposure)
Decnupaz
pivekimab sunirine · CD123No NOAEL in 13-week monkey study: thymic atrophy at the lowest dose (0.01 mg/kg)
Elahere
mirvetuximab soravtansine · FRαMonkey NOAEL 4 mg/kg: AUC margin 0.09 (AUC0-24 vs AUCtau) to 0.57 (AUC0-∞)
Kadcyla
ado-trastuzumab emtansine · HER2Monkey HNSTD 10 mg/kg (2040 µg DM1/m2) approximately equivalent to the clinical dose
Padcev
enfortumab vedotin · Nectin-4Monkey ~3-fold and rat (MTD) ~2-fold human systemic exposure at recommended dose
Tivdak
tisotumab vedotin · Tissue factorMonkey HNSTD 3 mg/kg ~1.35-2.56x human exposure (Cmax and AUC)
Trodelvy
sacituzumab govitecan · Trop-2Monkey NOAEL/HNSTD 50 mg/kg: 6.4x (total antibody), 4.6x (total SN-38), 3.1x (free SN-38) human exposure at 10 mg/kg
Zynlonta
loncastuximab tesirine · CD19Monkey 0.3 mg/kg ~3x human AUC at MRHD 0.15 mg/kg
Emrelis
telisotuzumab vedotin · c-MetNot stated in public reviews
Mylotarg
gemtuzumab ozogamicin · CD33Not stated in public reviews
Polivy
polatuzumab vedotin · CD79bNot stated in public reviews