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Tivdak: genotox, carcinogenicity and repro: done or skipped?

tisotumab vedotin · Tissue factor
Genotoxicity
Not conducted with ADC; MMAE: Ames and mouse lymphoma negative, rat micronucleus positive (aneugenic)
“Genetic toxicology studies were not conducted with tisotumab vedotin; rather, the applicant submitted studies that evaluated the payload.”
✓ VerifiedFDA multi-discipline review, p. 34Source ↗
Carcinogenicity
Not conducted (ICH S9)
“Carcinogenicity studies were not conducted with tisotumab vedotin in accordance with ICH S9 guidance.”
✓ VerifiedFDA multi-discipline review, p. 34Source ↗
Reproductive & developmental
Not conducted with ADC (ICH S9); MMAE rat EFD teratogenic/embryolethal; male repro toxicity in monkey
“MMAE was teratogenic and embryo lethal when administered to pregnant rats via two intravenous doses of 0.2 mg/kg during the period of organogenesis on gestational days 6 and 13.”
✓ VerifiedFDA multi-discipline review, p. 35Source ↗
Safety pharmacology
Incorporated into repeat-dose monkey studies (ICH S9); MMAE hERG in vitro
“Additionally, safety pharmacology endpoints for tisotumab vedotin representative of the cardiovascular (ECG and heart rate), central nervous (cageside observations) and respiratory systems (breaths per minute) were assessed as part of the repeat-dose toxicity studies as outlined in ICH S9 guideline.”
✓ VerifiedEMA assessment report, p. 35Source ↗

Same question, other ADCs

Adcetris

brentuximab vedotin · CD30
Conducted on MMAE: Ames and mouse lymphoma negative; rat micronucleus positive (aneugenic)

Besponsa

inotuzumab ozogamicin · CD22
Conducted: calicheamicin positive in Ames and in vitro micronucleus; ADC clastogenic in mouse micronucleus

Datroway

datopotamab deruxtecan · Trop-2
Not conducted with ADC; DXd Ames negative, clastogenic in vitro chromosome aberration and in vivo rat micronucleus

Decnupaz

pivekimab sunirine · CD123
Not conducted with ADC (ICH S9); FGN849 positive in Ames TA102, in vitro and in vivo micronucleus

Elahere

mirvetuximab soravtansine · FRα
Not conducted with ADC; DM4 and S-methyl-DM4 Ames negative, rat bone marrow micronucleus positive

Emrelis

telisotuzumab vedotin · c-Met
Not conducted with ADC; MMAE aneugenic (positive rat micronucleus), Ames and mouse lymphoma negative

Enhertu

fam-trastuzumab deruxtecan · HER2
Not conducted with ADC; DXd clastogenic (rat micronucleus, CHL chromosome aberration), Ames negative

Kadcyla

ado-trastuzumab emtansine · HER2
Conducted on DM1: Ames negative; rat micronucleus positive (aneugenic/clastogenic); monkey micronucleus inconclusive

Mylotarg

gemtuzumab ozogamicin · CD33
Conducted: ADC clastogenic in mouse micronucleus; free calicheamicin DMH mutagenic and clastogenic in vitro

Padcev

enfortumab vedotin · Nectin-4
Not conducted with ADC; MMAE Ames and mouse lymphoma negative, rat micronucleus positive (aneugenic)

Polivy

polatuzumab vedotin · CD79b
Not conducted with ADC; MMAE Ames and mouse lymphoma negative, rat micronucleus positive (aneugenic)

Trodelvy

sacituzumab govitecan · Trop-2
Not conducted with ADC; SN-38 Ames negative, in vitro micronucleus positive (clastogenic)

Zynlonta

loncastuximab tesirine · CD19
Not conducted with ADC; SG3199 clastogenic in vitro (micronucleus, chromosome aberration); Ames not assessable (cytotoxicity)

Summary across all 14 ADCs →