“Genetic toxicology studies are not applicable to mAbs and were not conducted with guselkumab based on ICH S6R1 guidance”
✓ VerifiedFDA multi-discipline review, p. 66Source ↗
Carcinogenicity
Not conducted; evidence does not support a link between IL-23 inhibition and increased cancer risk
“does not support a causal mechanistic/target-related link between IL-23 inhibition and increased cancer risk”
✓ VerifiedFDA multi-discipline review, p. 59Source ↗
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
Monkey ePPND: no adverse developmental effects up to 30 times the MRHD; neonatal deaths at 6- to 30-times the MRHD
“no adverse developmental effects were observed in infants born to pregnant monkeys after subcutaneous administration of guselkumab during organogenesis through parturition at doses up to 30 times the maximum recommended human dose (MRHD). Neonatal deaths were observed at 6- to 30-times the MRHD”
✓ VerifiedFDA multi-discipline review, p. 262Source ↗
Safety pharmacology
Dedicated cardiovascular study in telemetered cynomolgus monkeys
“A dedicated cardiovascular (CV) safety pharmacology study was undertaken in telemetered cynomolgus monkeys.”
“Genetic toxicology studies are not applicable to mAbs and were not conducted with guselkumab based on ICH S6R1 guidance, Guidance for Industry – Preclinical Safety Evaluation of Biotechnology-Derived Pharmaceuticals.”
✓ VerifiedFDA multi-discipline review, p. 66Source ↗
Genotox: in vitro mammalian
Not conducted (ICH S6R1)
“Genetic toxicology studies are not applicable to mAbs and were not conducted with guselkumab based on ICH S6R1 guidance, Guidance for Industry – Preclinical Safety Evaluation of Biotechnology-Derived Pharmaceuticals.”
✓ VerifiedFDA multi-discipline review, p. 66Source ↗
Genotox: in vivo
Not conducted (ICH S6R1)
“Genetic toxicology studies are not applicable to mAbs and were not conducted with guselkumab based on ICH S6R1 guidance, Guidance for Industry – Preclinical Safety Evaluation of Biotechnology-Derived Pharmaceuticals.”
✓ VerifiedFDA multi-discipline review, p. 66Source ↗
Carcinogenicity model
Not conducted: 2-year rodent study not feasible (binding specific to monkeys/guinea pigs)
“Guselkumab cannot be tested in a traditional 2-year rodent study to evaluate its carcinogenic potential due to its species specific binding in monkeys and/or guinea pigs.”
✓ VerifiedFDA multi-discipline review, p. 66Source ↗
Carcinogenicity timing
Not required; no nonclinical carcinogenicity studies recommended
“No nonclinical studies to address the carcinogenic potential of guselkumab are recommended.”
✓ VerifiedFDA multi-discipline review, p. 59Source ↗
hERG / QT
No hERG assay; telemetered monkey CV study: no adverse ECG or blood pressure effects
“There were no adverse effects on ECGs and no treatment related effects on blood pressure in this study.”
✓ VerifiedFDA multi-discipline review, p. 61Source ↗