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Kadcyla: how was the first human dose set?

ado-trastuzumab emtansine · HER2
First-in-human starting dose
HNSTD-based: monkey HNSTD 10 mg/kg (q3w x4), below 1/10 rat severely toxic dose, used to set Phase I start
“the highest non-severely toxic dose (HNSTD) in cynomolgus monkeys was 10 mg/kg for four injections every 3 weeks which was below the no observable adverse effect level in that species and below one-tenth of the severely toxic dose in rats, this information was used to determine a Phase I starting dose in humans.”
✓ VerifiedEMA assessment report, p. 36Source ↗
NOAEL / key findings
Monkey HNSTD 10 mg/kg q3w; liver enzymes, thrombocytopenia, lymphoid atrophy, axonal degeneration (sciatic nerve, spinal cord) at >=10 mg/kg
“Based on overall tolerability and reversibility of findings, the Applicant considered 10 mg/kg of trastuzumab emtansine given as four injections to Cynomolgus monkeys every 3 weeks to be the highest non-severely toxic dose.”
✓ VerifiedFDA pharmacology/toxicology review, p. 153Source ↗

Same question, other ADCs

Elahere

mirvetuximab soravtansine · FRα
Rationale not stated; FIH Study 0401 escalated from 0.15 mg/kg (TBW) to 7.0 mg/kg

Enhertu

fam-trastuzumab deruxtecan · HER2
1/12 HED of monkey HNSTD (0.8 mg/kg), also matching minimum effective trough concentration

Zynlonta

loncastuximab tesirine · CD19
1/6 HNSTD in cynomolgus monkey cited as rationale for species choice; actual FIH calculation not detailed

Adcetris

brentuximab vedotin · CD30
Not stated in public reviews

Besponsa

inotuzumab ozogamicin · CD22
Not stated in public reviews

Datroway

datopotamab deruxtecan · Trop-2
Not stated in public reviews

Decnupaz

pivekimab sunirine · CD123
Not stated in public reviews

Emrelis

telisotuzumab vedotin · c-Met
Not stated in public reviews

Mylotarg

gemtuzumab ozogamicin · CD33
Not stated in public reviews

Padcev

enfortumab vedotin · Nectin-4
Not stated in public reviews

Polivy

polatuzumab vedotin · CD79b
Not stated in public reviews

Tivdak

tisotumab vedotin · Tissue factor
Not stated in public reviews

Trodelvy

sacituzumab govitecan · Trop-2
Not stated in public reviews

Summary across all 14 ADCs →