ADC TOXICITY ATLAS
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Loncastuximab tesirine

FDA-approved
Zynlonta; ADCT-402
Sponsor
ADC Therapeutics
Indication
CD19+ DLBCL
Target family
Immunoglobulin superfamily
RP2D dose
0.15 mg/kg x2 then 0.075 mg/kg
Q3WRP2D
01
Multi-organ toxicity

Fingerprint & organ drill-down

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

Ocular

Any-grade
0%
G3+
0%
RP2D
sagittal schematic · Reversible

Tissues shaded by reported adverse-event rate.

Cornea
AE
-
Express.
0%
Limbus
AE
-
Express.
0%
Conjunctiva
AE
-
Express.
0%
Lens
AE
-
Express.
-
Retina / RPE
AE
-
Express.
0.05%
0 nTPM
Dominant tissue
-
Surface subtype
None
Reversibility
Reversible
Reported ocular events
No granular adverse-event rows recorded for this system.
Per-trial detail

Adverse events by trial

LOTIS-3 (Lonca + Ibrutinib)Phase 1/260 µg/kgn=37CTCAE NRCto verify
CT.gov NCT03684694 all-cause mortality (derived G5; includes non-AE/PD deaths) NCT03684694
122 adverse-event terms · 20 systems · expand a system below
Infections16
Conjunctivitis
16.2%
6/37
Oral candidiasis
8.1%
3/37
Urinary tract infection
8.1%
3/37
Corona virus infection
G3+ 5.4%
Pneumonia
5.4%G3+ 2.7%
2/37
Furuncle
5.4%
2/37
Sinusitis
5.4%
2/37
Folliculitis
G3+ 2.7%
Pneumocystis jirovecii infection
G3+ 2.7%
Pneumonia fungal
G3+ 2.7%
Progressive multifocal leukoencephalopathy
G3+ 2.7%
Urinary tract infection bacterial
G3+ 2.7%
Bronchitis
2.7%
1/37
Oral herpes
2.7%
1/37
Clostridium difficile colitis
2.7%
1/37
Upper respiratory tract infection
2.7%
1/37
GI13
Dermatologic13
Metabolic11
General10
Investigations10
Hematologic7
Pulmonary7
Cardiac5
Musculoskeletal5
Psychiatric5
Injury4
Neurologic (other)4
Vascular4
Ocular2
Vision blurred
2.7%
1/37
Ocular hyperaemia
2.7%
1/37
Renal2
Overall/Summary1
Ear1
Immune1
Neoplasms1
02
Construct

Molecular anatomy

Antibody
IgG1
Humanized
Linker
Cleavable
2.3
DAR
Payload
DNA cross-linker
Linker structureC41H65N5O15
[H]OC([H])([H])c1c([H])c([H])c(N([H])C(=O)[C@@]([H])(N([H])C(=O)[C@@]([H])(N([H])C(=O)C([H])([H])C([H])([H])OC([H])([H])C([H])([H])OC([H])([H])C([H])([H])OC([H])([H])C([H])([H])OC([H])([H])C([H])([H])OC([H])([H])C([H])([H])OC([H])([H])C([H])([H])OC([H])([H])C([H])([H])OC([H])([H])C([H])([H])N([H])C(=O)C([H])([H])C([H])([H])N2C(=O)C([H])=C([H])C2=O)C([H])(C([H])([H])[H])C([H])([H])[H])C([H])([H])[H])c([H])c1[H]
Payload structureC33H36N4O6
CC1=CN2[C@@H](C1)C=NC3=CC(=C(C=C3C2=O)OC)OCCCCCOC4=C(C=C5C(=C4)N=C[C@@H]6CC(=CN6C5=O)C)OC
03
Antibody

Antibody & Fc engineering

Antibody
hRB4v1.2 (loncastuximab)
Isotype
IgG1
Origin
Humanized
Fc modifications
None
Glycoengineering
Standard
Effector silencing
None
FcγR binding
Retained
C1q binding
Retained
Epitope / domain
CD19 extracellular domain
04
Linker & conjugation

Linker chemistry

Linker profile
Linker
VA dipeptide (tesirine)
Class
Cleavable
Cleavage
Cleavable
Attachment
Cysteine (interchain)
Conjugation
Conventional interchain Cys
Symmetry
Symmetric
DAR (mean)
2.3
DAR homogeneity
Heterogeneous
Plasma t½
20.8 d
Cleavage trigger
Cathepsin B (Val-Ala)
Release control
Conditional
Hydrophilicity mask
Discrete-PEG-spacer
Platform
Tesirine
Cell line
CHO
Formula
C41H65N5O15
Linker MW
867.991 Da
Linker TPSA
247.85 Ų
Linker xLogP
-0.2829
ADCdb linker
LIN0YRUBS
In-vitro stability
-
Stability note
Conjugated antibody steady-state t½ 20.6 d after ~15 weeks (Hamadani Blood 2021 LOTIS-2 popPK); 2-compartment linear model with time-dependent CL → t½ at C1 ≈ 13 d, increases on multiple dosing. PBD released as stable DNA-guanine adduct, not free drug; warhead toxicity not driven by free-drug circulating
05
Payload

Payload & physicochemistry

Payload profile
Payload
SG3199 (PBD dimer)
Class
PBD dimer
Mechanism
DNA cross-linker
Released catabolite
SG3199 (pyrrolobenzodiazepine [PBD] dimer)
Mechanistic subtype
DNA-crosslinker-PBD
Stereochem / salt
(11aS,11a'S)-configured PBD dimer (single defined stereoisomer); free base (no salt)
Bystander
Partial
PAMPA rank
6
MW
584.7 Da
XLogP3
2.8
logD₇.₄
2.5
TPSA
102 Ų
pKa
5 pKa
Charge pH 7.4
0
H-bond donors
0
H-bond acceptors
8
IC50 (HCEC)
-
Formula
C33H36N4O6
PubChem CID
90132565
ADCdb payload
PAY0LZRXU
Potency IC50 (nM)
151.5
CAS no.
1595275-62-9
Plasma protein binding (%)
95 %
Hydrophobicity · logD₇.₄
hydrophilic −2+2.5+4 lipophilic
Bioactivity note
SG3199 is a sequence-selective DNA minor-groove interstrand crosslinking PBD dimer; ADCdb lists its molecular target as human DNA (hDNA). No numeric IC50 reported on the ADCdb ADC page or the PubChem record.
06
Dosing & regimen

Dosing

RP2D dose
0.15 mg/kg x2 then 0.075 mg/kg
Schedule
Q3W
Route
IV
Fractionated
No
n at RP2D
145
Dose basis
TBW
Trial phase
Approved
Dose-OAE available
No
Tox summary basis
RP2D
ADA rate (%)
2 %
07
Pharmacology

Clinical pharmacokinetics

By analyte · FDA label §12.3 + Drugs@FDA clinical-pharmacology reviews
Intact ADCTotal antibodyFree payload
Cmax
2911 (geometric mean; CV 35.3%)ng/mL+4
AUC
21665 (AUCtau; geometric mean; CV 54.1%)ng*day/mL+4
Tmax
near end of infusion (approx end of 30-min IV infusion)
20.8 (mean; SD 7.06)days+1
CL
0.499 (geometric mean; CV 89.3%; total CL after single dose)L/day+2
0.218 (typical patient; linear CL, common with conjugated antibody in popPK model)L/day
1.9 (popPK estimate CLSG; RSE 16.6%; BSV 124.9%)L/day
Vd
7.11 (geometric mean steady-state Vss; CV 26.6%)L+1
0.0492 (popPK estimate V5; RSE 23.0%)L
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
0 %
OAE grade 3+
0 %
OAE data status
documented-absent
Severity (weighted)
0
Keratopathy
-
Conjunctival
-
Dry eye
-
Blurred vision
-
Dominant tissue
-
Surface subtype
None
Grading scale
CTCAE v4.0
Reversibility
Reversible
Target expression in eye tissues (HCA detection · HPA bulk)
Cornea (central)
0 %
Cornea (limbal)
0 %
Conjunctiva
0 %
RPE
0.05 %
Retina (HPA)
0 nTPM
Cross-trial comparability · source-verified
Ascertainment: Symptom-driven reportingScale: CTCAE v4Denominator: RP2D⚠ Not comparable: symptom-driven ascertainment
Dose & schedule → ocular toxicity · ocular AE (any-grade) by cohort
90 μg/kg
Q3W
25%
n=4 · ADCT-402 Ph1 B-ALL
15 μg/kg
Q3W
25%
n=4 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
75 µg/kg
25%
n=4 · LOTIS-3 (Lonca + Ibrutinib)
120 μg/kg
Q3W
20%
n=5 · ADCT-402 Ph1 B-ALL
30 μg/kg
Q3W
14.3%
n=7 · ADCT-402 Ph1 B-ALL
120 μg/kg
Q3W
12.5%
n=16 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
see line_context
10%
n=10 · LOTIS-3 (Lonca + Ibrutinib)
see line_context
6.7%
n=30 · LOTIS-3 (Lonca + Ibrutinib)
see line_context
5.9%
n=17 · Lonca-R, untreated DLBCL (Ph2)
200 μg/kg
Q3W
5.6%
n=36 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
150 μg/kg
Q3W
5.3%
n=19 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
150 μg/kg
Q3W
4.3%
n=69 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
60 µg/kg
2.7%
n=37 · LOTIS-3 (Lonca + Ibrutinib)
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
loncastuximab-tesirine
Approval status
FDA-approved
Approval year
2021
UniProt
P15391
ADCdb ADC
DRG0TKVCB
ADCdb antibody
ANI0AWZRF
ADCdb target
TAR0EBTXG
Primary source
FDA Zynlonta label; Caimi LOTIS-2 Lancet Oncol 2021
Aliases & development codes
Zynlonta; ADCT-402
Notes
PBD warhead released as DNA-guanine adduct, not free drug