← Atlas
Datopotamab deruxtecan FDA-approved Datroway; Dato-DXd; DS-1062
Sponsor
Daiichi Sankyo/AstraZeneca
Indication
TACSTD2+ breast/NSCLC
Target family
TACSTD / EpCAM-TROP
01 Multi-organ toxicity
Fingerprint & organ drill-down Any-grade Grade 3+
Ocular
38%
Hepatic
24%
Neutrop.
30%
Thrombo.
-
Anemia
35%
GI
56%
ILD
2.4%
Neuro.
-
Also reported Other · 12 · 4 systems
6 adverse-event terms
Ocular Toxicity Target expression Compare
sagittal schematic · Reversible
↳ Tissues shaded by reported adverse-event rate.
Off-target signature
24% corneal toxicity, yet the TROP-2 target is detected in only 65.43% of central cornea - toxicity is not explained by target expression.
Dominant tissue
Ocular surface
Surface subtype
Corneal (off-target)
Reported ocular events
Ocular toxicity (any ocular adverse reaction) 38%
Blepharitis; Meibomian gland dysfunction; Blurred vision (named ocular PTs without quantified rate) -
Per-trial detail
Adverse events by trial BEGONIA · Phase 1b/2 — 112 events, n=62 TROPION-Lung01 · Phase 3 — 99 events, n=299 TROPION-Breast01 · Phase 3 — 78 events, n=365 DS1062a Chinese bridging (NSCLC/TNBC) · Phase 1/2 — 70 events, n=40 TROPION-Lung05 · Phase 2 — 67 events, n=137 TROPION-Breast01 · Approved — 20 events, n=360 TROPION-Breast02 · Approved — 20 events, n=319 TROPION-Lung05/Lung01/PanTumor01 (pooled EGFR-mutated NSCLC) · Phase 1/2/3 (pooled) — 18 events, n=125 TROPION-Lung01 · Approved — 17 events, n=125 DS1062a Chinese bridging (NSCLC/TNBC) · Phase 1/2 — 15 events, n=79 BEGONIA · Phase 1b/2 — 12 events, n=33 TROPION-Breast02 · Phase 3 — 11 events, n=319 TROPION-Breast01 · Phase 3 — 8 events, n=360 TROPION-Lung05; TROPION-Lung01 · Approved — 8 events, n=125 TROPION-Lung05/Lung01/PanTumor01 (pooled EGFR-mutated NSCLC) · Phase 1/2/3 (pooled) — 7 events, n=125 Pooled DATROWAY safety population · Approved — 5 events, n=1365 TROPION-Breast01 · Phase 3 — 3 events, n=360 TROPION-Breast02 · Phase 3 — 3 events, n=319 DATROWAY pooled all-indication safety (single agent 6 mg/kg) · Pooled — 2 events, n=1365 Unattributed cohort — 2 events, n=1365 Unattributed cohort — 2 events, n=317 DATROWAY pooled all-indication safety (single agent 6 mg/kg) · Pooled — 1 event, n=1365 DATROWAY pooled all-indication safety (single agent 6 mg/kg) · Pooled — 1 event, n=1365 Pooled breast cancer safety population (TROPION-Breast01 + TROPION-Breast02) · Approved — 1 event, n=841 DATROWAY pooled breast safety (TROPION-Breast01/Breast02/PanTumor01/PanTumor02) · Pooled — 1 event, n=841 DATROWAY pooled breast safety (TROPION-Breast01/Breast02/PanTumor01/PanTumor02) · Pooled — 1 event, n=841 DATROWAY pooled NSCLC safety (TROPION-Lung01/Lung05/PanTumor01) · Pooled — 1 event, n=484 DATROWAY pooled NSCLC safety (TROPION-Lung01/Lung05/PanTumor01) · Pooled — 1 event, n=484 TROPION-Breast01 · Phase 3 — 1 event, n=360 TROPION-Breast02 · Phase 3 — 1 event, n=319 TROPION-Lung05/Lung01/PanTumor01 (pooled EGFR-mutated NSCLC) · Pooled — 1 event, n=125 TROPION-PanTumor01 · Phase 1 — 1 event, n=44 TROPION-PanTumor01 · Phase 1 — 1 event, n=41 BEGONIA Phase 1b/2 6 mg/kg (Dato) + 1120 mg durvalumab IV every 3 weeks n=62 CTCAE NR (CT.gov serious/non B
CT.gov NCT03742102 posted results (Other/non-serious AE module, all-cause, threshold 5%; MedDRA 26.0 & 27.1) NCT03742102 arm EG004 (Durvalumab + Dato-DXd); CT.gov AE module otherEvents
112 adverse-event terms · 22 systems · expand a system below
Stomatitis
69.35% G3+ 1.61%
Gastrooesophageal reflux disease
6.45%
Abdominal discomfort
1.61%
Abdominal pain upper
1.61%
Lacrimation increased
11.29%
Limbal stem cell deficiency
6.45%
02 Construct
Molecular anatomy Linker structure C25H31N5O8
[H]OC(=O)C([H])([H])N([H])C(=O)[C@@]([H])(N([H])C(=O)C([H])([H])N([H])C(=O)C([H])([H])N([H])C(=O)C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])N1C(=O)C([H])=C([H])C1=O)C([H])([H])c1c([H])c([H])c([H])c([H])c1[H] copy
Payload structure C26H24FN3O6
CCC1(C2=C(COC1=O)C(=O)N3CC4=C5C(CCC6=C5C(=CC(=C6C)F)N=C4C3=C2)NC(=O)CO)O copy
03 Antibody
Antibody & Fc engineering Attachment
Cysteine (interchain)
Conjugation
Conventional interchain Cys
DAR homogeneity
Heterogeneous
Cleavage trigger
Cathepsin B/L (GGFG tetrapeptide)
Release control
Conditional
Hydrophilicity mask
Hydrophilic-linker
In-vitro stability
>94%@21d/plasma
Stability note
Median elimination t½ 4.8 d (range 1.0–8.2) for Dato-DXd; released DXd t½ ~5.5 d. Same linker chemistry as T-DXd (1–2% DXd released at 21 d in plasma); shorter t½ than T-DXd reflects DAR 4 vs DAR 8 + datopotamab antibody PK
Class
Topoisomerase I inhibitor
Hydrophobicity · logD₇.₄
hydrophilic −2 +1.4 +4 lipophilic
Bioactivity note
DXd is a potent DNA topoisomerase I (TOP1) inhibitor (literature IC50 ~0.3 uM cell-free TOP1; ADCdb lists therapeutic target DNA topoisomerase 1 / PATR0EGDKN). ADCdb ADC entry reports clinical efficacy (ORR ~24-39% across NSCLC/TNBC cohorts) but no ADC binding constant or payload
07 Pharmacology
Clinical pharmacokinetics By analyte · FDA label §12.3 + Drugs@FDA clinical-pharmacology reviews
Intact ADC Total antibody Free payload Cmax 154 µg/mL
— 2.8 ng/mL
AUC 671 µg*day/mL
— 18 ng*day/mL
t½ 4.8 days
5.23 days
5.5 days
CL 0.6 L/day
— 3 L/h
Vd 3.5 L +1
— —
FDA label §12.3 Drugs@FDA reviewhover a value for dose / population / source · “+N” marks additional reported values
08 Ocular & expression
Ocular profile & eye-tissue target expression Target profile → Dominant tissue
Ocular surface
Surface subtype
Corneal (off-target)
Target expression in eye tissues (HCA detection · HPA bulk)
Cross-trial comparability · source-verified
Ascertainment: Systematic eye exams Scale: CTCAE v5 Denominator: RP2D
Dose & schedule → ocular toxicity · keratopathy (any-grade) by cohort
n=1365 · DATROWAY pooled all-indication safety (single agent 6 mg/kg)
6 mg/kg
Q3W (Day 1 of 21-day cycle)
n=319 · TROPION-Breast02
6 mg/kg
Q3W (Day 1 of 21-day cycle)
n=360 · TROPION-Breast01
6 mg/kg (Dato) + 1120 mg durvalumab
IV every 3 weeks
n=62 · BEGONIA
6 mg/kg
IV every 3 weeks (21-day cycle)
n=1365 · Pooled DATROWAY safety population
n=125 · TROPION-Lung05/Lung01/PanTumor01 (pooled EGFR-mutated NSCLC)
6 mg/kg
IV every 3 weeks (21-day cycle)
n=125 · TROPION-Lung05; TROPION-Lung01
n=40 · DS1062a Chinese bridging (NSCLC/TNBC)
Per-cohort rates from the per-trial extraction, sorted by dose. Cross-trial comparison is subject to ascertainment / scale differences (see comparability above) — e.g. an early symptom-driven trial can read lower than a later systematic-exam trial at a higher dose.
Ocular AE grading reference — interspecialty consensus · 6 scales + dose modification 09 Identity & registry
Identifiers, registry & notes ADC id
datopotamab-deruxtecan
Approval status
FDA-approved
Primary source
DATROWAY HCP; TROPION-Breast01 JCO 2024
Aliases & development codes
Datroway; Dato-DXd; DS-1062
Notes
V3.1: OAE values corrected to DATROWAY label pooled values (36% any, 2.2% G3+; prev 51/1.9 was TROPION-Breast01-specific subset). Severity ratio 0.06 after correction. Retains surface-dominant pattern.