Ames negative; clastogenic in vitro (human lymphocyte micronucleus); negative in vivo rat bone marrow micronucleus and liver comet
“Inavolisib was not mutagenic in the bacterial reverse mutation (Ames) assay. Inavolisib was clastogenic in an in vitro human lymphocyte micronucleus assay. Inavolisib was not genotoxic in an in vivo rat bone marrow micronucleus test and did not induce DNA break in a liver comet assay.”
Not conducted (advanced cancer indication, ICH S9)
“Carcinogenicity studies were not conducted, nor warranted, with inavolisib to support the proposed indication in patients with advanced cancer in accordance with ICH S9 guidance.”
✓ VerifiedFDA multi-discipline review, p. 41Source ↗
Instead of carcinogenicity
Not stated in public reviews
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
Instead of genotoxicity
Not stated in public reviews
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
DRG histopathology
Not stated in public reviews
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
Reproductive & developmental
Rat EFD: reduced fetal weight, post-implantation loss and malformations at ≥2 mg/kg (≥0.9x human AUC)
“Administration of inavolisib resulted in dose dependent effects on embryo-fetal development at ≥2 mg/kg ( ≥ 0.9 times the human exposure at the recommended dose of 9 mg/day based on AUC) that included decreases in fetal body weight and placental weight, post-implantation loss, lower fetal viability, fetal malformations”
✓ VerifiedFDA multi-discipline review, p. 42Source ↗
Safety pharmacology
Dog telemetry: reversible decreased heart rate, increased arterial pressure and minimal QTc lengthening (+11 msec) at ≥0.3 mg/kg
“In a GLP-compliant single dose safety pharmacology study in telemetry instrumented Beagle dogs, inavolisib-related cardiovascular effects included generally dose-dependent, reversible decreases in heart rate, increases in arterial pressure and contractility, lengthening of PR and QT intervals (likely driven by the decreased heart rates), and minimally lengthened corrected QT (QTc) interval (+11 msec/+5%) at doses ≥ 0.3 mg/kg.”
✓ VerifiedFDA multi-discipline review, p. 40Source ↗
Genotox: Ames
Negative (not mutagenic in bacterial reverse mutation assay)
“In GLP-compliant genetic toxicology studies, inavolisib was not mutagenic in the bacterial reverse mutation assay.”
✓ VerifiedFDA multi-discipline review, p. 41Source ↗
Genotox: in vitro mammalian
Positive: clastogenic in in vitro human lymphocyte micronucleus assay
“Inavolisib was clastogenic in an in vitro human lymphocyte micronucleus assay.”
✓ VerifiedFDA multi-discipline review, p. 41Source ↗
Genotox: in vivo
Negative: rat bone marrow micronucleus and liver alkaline Comet assay
“Inavolisib treatment did not cause a significant increase in micronucleus frequency in polychromatic erythrocytes of the bone marrow and did not induce DNA strand breaks in the liver above the historical control range when evaluated by the alkaline Comet assay.”
✓ VerifiedFDA multi-discipline review, p. 41Source ↗
Carcinogenicity model
Not conducted (advanced cancer indication, ICH S9)
“Carcinogenicity studies were not conducted, nor warranted, with inavolisib to support the proposed indication in patients with advanced cancer in accordance with ICH S9 guidance.”
✓ VerifiedFDA multi-discipline review, p. 41Source ↗
Carcinogenicity timing
Not required for advanced cancer (ICH S9); none conducted
“FDA agrees that carcinogenicity studies are not warranted to support the proposed indication in patients with advanced cancer in accordance with ICH S9 guidance.”
✓ VerifiedFDA multi-discipline review, p. 59Source ↗
hERG / QT
hERG IC50 >1700x human unbound Cmax (0.116 µM) at 9 mg
“The IC50 for inhibition of hERG current was > 1700 times higher than the human plasma Cmax [unbound] (0.116 µM) at the 9 mg dose.”
Not genotoxic overall: Ames negative; in vitro chromosome aberration positive without (not with) metabolic activation; rat micronucleus and comet negative