Conducted on DM1: Ames negative; rat micronucleus positive (aneugenic/clastogenic); monkey micronucleus inconclusive
“DM1 was positive in an in vivo rat bone marrow micronucleus assay at exposures similar to the mean maximum concentrations of DM1 in patients in clinical trials, which is consistent with its mechanism of action.”
✓ VerifiedFDA pharmacology/toxicology review, p. 6Source ↗
Carcinogenicity
Not conducted (not required, advanced cancer)
“8 Carcinogenicity Not required and not submitted.”
✓ VerifiedFDA pharmacology/toxicology review, p. 132Source ↗
Reproductive & developmental
Not conducted (ICH S9; relied on trastuzumab data and DM1 mechanism); fertility effects from general tox
“Based on these findings and consistent with ICH S9, embryo-fetal developmental toxicity studies were not required for the indicated patient population.”
✓ VerifiedFDA pharmacology/toxicology review, p. 6Source ↗
Safety pharmacology
Dedicated single-dose CV/respiratory telemetry study in female cynomolgus plus in vitro hERG with DM1
“Free DM1 does not inhibit the cardiac slow rectifier current at physiologically relevant concentrations. Trastuzumab emtansine does not cause changes in the monkey ECG but it does cause some elevation in blood pressures.”
✓ VerifiedFDA pharmacology/toxicology review, p. 15Source ↗