Trodelvy (sacituzumab govitecan): how was the first human dose set?

Precedia/Antibody-drug conjugates/Trodelvy/First dose

Trodelvy: how was the first human dose set?

sacituzumab govitecan · Trop-2

First-in-human starting dose

Not stated in public reviews

Why it's blank

The public FDA and EMA reviews of Trodelvy 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 ADCs

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: Acute study HNSTD 60 mg/kg (no NOAEL); 13-week NOAEL/HNSTD 50 mg/kg; bone marrow, lymphoid, GI, liver, skin, female reproductive organs (EMA assessment report, p. 30)

Full method, every step sourced →

NOAEL / key findings

Acute study HNSTD 60 mg/kg (no NOAEL); 13-week NOAEL/HNSTD 50 mg/kg; bone marrow, lymphoid, GI, liver, skin, female reproductive organs

“In the absence of a NOAEL, the HNSTD in this study was 60 mg/kg/dose.”

✓ VerifiedEMA assessment report, p. 30Source ↗

Summary across all 14 ADCs →

Trodelvy: how was the first human dose set?

Same question, other ADCs

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