ADC TOXICITY ATLAS
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Datopotamab deruxtecan

FDA-approved
Datroway; Dato-DXd; DS-1062
Sponsor
Daiichi Sankyo/AstraZeneca
Indication
TACSTD2+ breast/NSCLC
Target family
TACSTD / EpCAM-TROP
RP2D dose
6 mg/kg
Q3WRP2D
01
Multi-organ toxicity

Fingerprint & organ drill-down

Also reported
0%severity100%
0
Assessed · clear
true 0%
No data
never assessed
6 adverse-event terms

Ocular

Any-grade
38%
G3+
3.4%
RP2D
sagittal schematic · Reversible

Tissues shaded by reported adverse-event rate.

Cornea
AE
24%
Express.
65.43%
Limbus
AE
-
Express.
73.31%
Conjunctiva
AE
-
Express.
86.39%
Lens
AE
-
Express.
-
Retina / RPE
AE
-
Express.
0%
0 nTPM
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)
Reversibility
Reversible
Reported ocular events
Ocular toxicity (any ocular adverse reaction)38%
G3+ 3.4%n=1365
Keratitis26%
G3+ 6%n=319
Dry eye26%
G3+ 1.3%n=319
Lacrimation increased6%
n=1365
Conjunctivitis5%
n=1365
Blepharitis; Meibomian gland dysfunction; Blurred vision (named ocular PTs without quantified rate)-
n=1365
Per-trial detail

Adverse events by trial

BEGONIAPhase 1b/26 mg/kg (Dato) + 1120 mg durvalumab IV every 3 weeksn=62CTCAE NR (CT.gov serious/nonB
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
GI14
Stomatitis
69.35%G3+ 1.61%
43/62
Nausea
67.74%
42/62
Constipation
50%
31/62
Vomiting
29.03%G3+ 1.61%
18/62
Diarrhoea
16.13%
10/62
Abdominal pain
9.68%
6/62
Dry mouth
9.68%
6/62
Dyspepsia
9.68%
6/62
Gastrooesophageal reflux disease
6.45%
4/62
Haemorrhoids
6.45%
4/62
Gastritis
3.23%
2/62
Abdominal discomfort
1.61%
1/62
Abdominal pain upper
1.61%
1/62
Toothache
1.61%
1/62
Infections11
Investigations11
Dermatologic11
General8
Musculoskeletal8
Pulmonary7
Ocular6
Dry eye
27.42%
17/62
Keratitis
16.13%
10/62
Lacrimation increased
11.29%
7/62
Vision blurred
8.06%
5/62
Limbal stem cell deficiency
6.45%
4/62
Punctate keratitis
1.61%
1/62
Metabolic6
Neurologic (other)6
Hepatic3
Neoplasms3
Vascular3
Hematologic2
Endocrine2
Immune2
Injury2
Psychiatric2
Renal2
Cardiac1
Ear1
Other1
02
Construct

Molecular anatomy

Antibody
IgG1
Humanized
Linker
Cleavable
4
DAR
Payload
TopoI inhibitor
Linker structureC25H31N5O8
[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]
Payload structureC26H24FN3O6
CCC1(C2=C(COC1=O)C(=O)N3CC4=C5C(CCC6=C5C(=CC(=C6C)F)N=C4C3=C2)NC(=O)CO)O
03
Antibody

Antibody & Fc engineering

Antibody
datopotamab
Isotype
IgG1
Origin
Humanized
Fc modifications
None
Glycoengineering
Standard
Effector silencing
None
FcγR binding
Retained
C1q binding
Retained
Target KD (nM)
0.74
Dev code
MAAP-9001a
04
Linker & conjugation

Linker chemistry

Linker profile
Linker
GGFG tetrapeptide
Class
Cleavable
Cleavage
Cleavable
Attachment
Cysteine (interchain)
Conjugation
Conventional interchain Cys
Symmetry
Symmetric
DAR (mean)
4
DAR homogeneity
Heterogeneous
Plasma t½
4.8 d
Cleavage trigger
Cathepsin B/L (GGFG tetrapeptide)
Release control
Conditional
Hydrophilicity mask
Hydrophilic-linker
Platform
DXd ADC platform
Formula
C25H31N5O8
Linker MW
529.55 Da
Linker TPSA
191.08 Ų
Linker xLogP
-1.3675
ADCdb linker
LIN0ECMCR
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
05
Payload

Payload & physicochemistry

Payload profile
Payload
DXd
Class
Topoisomerase I inhibitor
Mechanism
TopoI inhibitor
Released catabolite
DXd
Mechanistic subtype
TopoI
Stereochem / salt
-
Bystander
Yes
PAMPA rank
3
MW
493.5 Da
XLogP3
0
logD₇.₄
1.4
TPSA
129 Ų
pKa
9.2 pKa
Charge pH 7.4
+1
H-bond donors
3
H-bond acceptors
8
IC50 (HCEC)
-
Formula
C26H24FN3O6
PubChem CID
146160902
ADCdb payload
PAY0UXDSB
CAS no.
1599440-33-1
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
06
Dosing & regimen

Dosing

RP2D dose
6 mg/kg
Schedule
Q3W
Route
IV
Fractionated
No
n at RP2D
360
Dose basis
TBW
Trial phase
Approved
Dose-OAE available
No
Tox summary basis
RP2D
07
Pharmacology

Clinical pharmacokinetics

By analyte · FDA label §12.3 + Drugs@FDA clinical-pharmacology reviews
Intact ADCTotal antibodyFree payload
Cmax
154µg/mL
2.8ng/mL
AUC
671µg*day/mL
18ng*day/mL
4.8days
5.23days
5.5days
CL
0.6L/day
3L/h
Vd
3.5L+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
OAE any-grade
38 %
OAE grade 3+
3.4 %
OAE data status
reported
Severity (weighted)
13.8
Keratopathy
24 %
Conjunctival
-
Dry eye
27 %
Blurred vision
-
Dominant tissue
Ocular surface
Surface subtype
Corneal (off-target)
Grading scale
CTCAE v5.0
Reversibility
Reversible
Target expression in eye tissues (HCA detection · HPA bulk)
Cornea (central)
65.43 %
Cornea (limbal)
73.31 %
Conjunctiva
86.39 %
RPE
0 %
Retina (HPA)
0 nTPM
Cross-trial comparability · source-verified
Ascertainment: Systematic eye examsScale: CTCAE v5Denominator: RP2D
Dose & schedule → ocular toxicity · keratopathy (any-grade) by cohort
6 mg/kg
IV every 3 weeks
38%
n=1365 · DATROWAY pooled all-indication safety (single agent 6 mg/kg)
6 mg/kg
Q3W (Day 1 of 21-day cycle)
26%
n=319 · TROPION-Breast02
6 mg/kg
Q3W (Day 1 of 21-day cycle)
24%
n=360 · TROPION-Breast01
6 mg/kg (Dato) + 1120 mg durvalumab
IV every 3 weeks
16.13%
n=62 · BEGONIA
6 mg/kg
IV every 3 weeks (21-day cycle)
16%
n=1365 · Pooled DATROWAY safety population
6 mg/kg
IV every 3 weeks
12%
n=125 · TROPION-Lung05/Lung01/PanTumor01 (pooled EGFR-mutated NSCLC)
6 mg/kg
IV every 3 weeks (21-day cycle)
12%
n=125 · TROPION-Lung05; TROPION-Lung01
6 mg/kg
IV every 3 weeks
11.94%
n=365 · TROPION-Breast01
6 mg/kg
IV every 3 weeks
7.5%
n=40 · DS1062a Chinese bridging (NSCLC/TNBC)
6 mg/kg
IV every 3 weeks
5.11%
n=137 · TROPION-Lung05
6 mg/kg
IV every 3 weeks
0.34%
n=299 · TROPION-Lung01
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
Approval year
2025
UniProt
P09758
ADCdb ADC
DRG0ZOYQV
ADCdb antibody
ANI0WKJOW
ADCdb target
TAR0MIBZW
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.