Negative in Ames and rat in vivo micronucleus/comet (liver, duodenum) assays
“Zongertinib was negative for genotoxicity in the following studies: an in vitro bacterial reverse mutation (Ames) assay in the presence or absence of microsomal (S9) mix, and an in vivo peripheral blood micronucleus test coupled with comet assays conducted in hepatic and duodenal tissue isolated from male rats”
✓ VerifiedFDA multi-discipline review, p. 48Source ↗
Carcinogenicity
Not conducted (advanced cancer indication, ICH S9)
“Consistent with the principles discussed in the ICH S9 guidance, carcinogenicity studies are not expected for development of a drug intended for the treatment of patients with advanced cancer.”
✓ VerifiedFDA multi-discipline review, p. 48Source ↗
Reproductive & developmental
Rat EFD: delayed urinary system development and kidney hydronephrosis at 60 mg/kg/day (~19x human AUC)
“Zongertinib caused delayed development of the urinary system and kidney hydronephrosis at 60 mg/kg/day (approximately 19 times the human exposure based on AUC at the recommended dose).”
✓ VerifiedFDA multi-discipline review, p. 49Source ↗
Safety pharmacology
hERG IC50 11.41 µM (~380-fold free Cmax); no cardiovascular toxicity in dog telemetry
“Zongertinib inhibited in vitro human ether-à-go-go related gene (hERG) potassium channel current with an IC50 of 11.41 µM in a safety pharmacology assessment, which is approximately 380-fold higher than the human free steady-state Cmax of 30 nM. Additional cardiovascular safety pharmacology assessments did not reveal cardiovascular toxicity in telemetered conscious dogs”
✓ VerifiedFDA multi-discipline review, p. 47Source ↗
Not genotoxic overall: Ames negative; in vitro chromosome aberration positive without (not with) metabolic activation; rat micronucleus and comet negative