Positive in in vivo rat micronucleus assays; negative in Ames and in vitro TK6 clastogenicity assay
“Zidesamtinib was genotoxic in the in vivo rat micronucleus assays. Zidesamtinib was not mutagenic in the in vitro bacterial reverse mutation (Ames) assay or clastogenic in an in vitro assay in human lymphoblastoid TK6 cells.”
Not conducted (advanced cancer indication, ICH S9)
“Consistent with concepts described in the ICH S9 guidance (U.S. Food and Drug Administration, 2010), carcinogenicity studies were not conducted with zidesamtinib, nor were they warranted.”
✓ VerifiedFDA multi-discipline review, p. 38Source ↗
Reproductive & developmental
Rat EFD: 100% post-implantation loss at ≥8 mg/kg/day (about 3.5x human AUC)
“There was 100% post-implantation loss at ≥8 mg/kg/day (approximately 3.5 times the human exposure based on AUC at the recommended dose).”
✓ VerifiedFDA multi-discipline review, p. 39Source ↗
Safety pharmacology
hERG IC50 73.9 µM (~161-fold free Cmax); 11% QTc increase in telemetered dogs at 30 mg/kg
“zidesamtinib inhibited in vitro human ether-à-go-go related gene (hERG) potassium channel current with an IC50 of 73.9 µM, which is approximately 161-fold higher than the human free steady-state Cmax. Additional cardiovascular safety pharmacology assessment identified an 11% increase in QTc prolongation in telemetered conscious dogs following a single oral administration of zidesamtinib at 30 mg/kg/day.”
✓ VerifiedFDA multi-discipline review, p. 37Source ↗
Not genotoxic overall: Ames negative; in vitro chromosome aberration positive without (not with) metabolic activation; rat micronucleus and comet negative