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First-in-human starting dose
Not stated in public reviews
Why it's blank

The public FDA and EMA reviews of Lynozyfic don't say how the first human dose was chosen. That rationale is in the IND, which is confidential, so it is missing for most approved products.

How it's usually set for multispecifics

ADCs with cytotoxic payloads follow the S9 rules (1/10 STD10 or 1/6 HNSTD of the ADC, scaled by body surface area). For immune agonists, a MABEL-based start dose should be considered instead.

“For example, for cytotoxic payloads, the starting clinical dose can be determined using either 1/10th the Severely Toxic Dose (STD) in 10% of animals (STD10) in rodents or 1/6th the Highest Non- Severely Toxic Dose (HNSTD) in non-rodents, for the ADC based on body surface area, depending on which is the most appropriate and/or sensitive species.”
✓ VerifiedICH 2018: ICH S9 Guideline: Nonclinical Evaluation for Anticancer…, p. 15Source ↗
This product's starting point

NOAEL / key findings: 5-week: HNSTD 10 mg/kg/wk; 9/14-week: NOAEL not determined (early sacrifice at all doses; multi-organ inflammation, peritonitis/pleuritis, body weight loss) (EMA assessment report, p. 36)

Full method, every step sourced →

NOAEL / key findings
5-week: HNSTD 10 mg/kg/wk; 9/14-week: NOAEL not determined (early sacrifice at all doses; multi-organ inflammation, peritonitis/pleuritis, body weight loss)
“In the 9- or 14-week study, a NOAEL could not be determined.”
✓ VerifiedEMA assessment report, p. 36Source ↗

Same question, other multispecifics

Columvi

glofitamab · CD20 x CD3
MABEL: monkey PK/PD IL-6 excursion model plus in vitro human/monkey whole-blood cytokine data; 5 ug flat dose

Lunsumio

mosunetuzumab · CD20 x CD3
MABEL-type: EC20 from in vitro human PBMC cytokine release / T-cell activation assay

Vabysmo

faricimab · VEGF-A x Ang-2
Starting dose 0.5 mg/eye IVT supported by monkey tox data (6 mg/eye high dose not initially supported; dose escalation gated)

Bizengri

zenocutuzumab · HER2 x HER3
Not stated in public reviews

Blincyto

blinatumomab · CD19 x CD3
Not stated in public reviews

Elrexfio

elranatamab · BCMA x CD3
Not stated in public reviews

Epkinly

epcoritamab · CD20 x CD3
Not stated in public reviews

Hemlibra

emicizumab · FIXa x FX
Not stated in public reviews

Imdelltra

tarlatamab · DLL3 x CD3
Not stated in public reviews

Kimmtrak

tebentafusp · CD3 x gp100 (TCR fusion)
Not stated in public reviews

Korjuny

catumaxomab · EpCAM x CD3
Not stated in public reviews

Ordspono

odronextamab · CD20 x CD3
Not stated in public reviews

Removab

catumaxomab · EpCAM x CD3
Not stated in public reviews

Rybrevant

amivantamab · EGFR x MET
Not stated in public reviews

Talvey

talquetamab · GPRC5D x CD3
Not stated in public reviews

Tecvayli

teclistamab · BCMA x CD3
Not stated in public reviews

Ziihera

zanidatamab · HER2 x HER2 (biparatopic)
Not stated in public reviews

Summary across all 18 multispecifics →