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Loncastuximab tesirine FDA-approved Zynlonta; ADCT-402
Target family
Immunoglobulin superfamily
RP2D dose
0.15 mg/kg x2 then 0.075 mg/kg Q3W RP2D
01 Multi-organ toxicity
Fingerprint & organ drill-down Any-grade Grade 3+
Ocular
0%
Hepatic
57%
Neutrop.
52%
Thrombo.
58%
Anemia
51%
GI
23%
ILD
-
Neuro.
-
Also reported Other · 33 · 7 systems
0 adverse-event terms
Ocular Toxicity Target expression Compare
sagittal schematic · Reversible
↳ Tissues shaded by reported adverse-event rate.
Reported ocular events
No granular adverse-event rows recorded for this system.
Per-trial detail
Adverse events by trial LOTIS-3 (Lonca + Ibrutinib) · Phase 1/2 — 122 events, n=37 Lonca-R, untreated DLBCL (Ph2) · Phase 2 — 120 events, n=17 LOTIS-1 (ADCT-402 Ph1 B-NHL) · Phase 1 — 114 events, n=36 LOTIS-3 (Lonca + Ibrutinib) · Phase 1/2 — 108 events, n=49 ADCT-402 Ph1 B-ALL · Phase 1 — 93 events, n=6 LOTIS-2 · Phase 2 — 90 events, n=145 LOTIS-1 (ADCT-402 Ph1 B-NHL) · Phase 1 — 79 events, n=19 LOTIS-1 (ADCT-402 Ph1 B-NHL) · Phase 1 — 72 events, n=69 ADCT-402 Ph1 B-ALL · Phase 1 — 67 events, n=5 LOTIS-1 (ADCT-402 Ph1 B-NHL) · Phase 1 — 66 events, n=16 LOTIS-1 (ADCT-402 Ph1 B-NHL) · Phase 1 — 57 events, n=5 LOTIS-1 (ADCT-402 Ph1 B-NHL) · Phase 1 — 52 events, n=26 ADCT-402 Ph1 B-ALL · Phase 1 — 51 events, n=7 ADCT-402 Ph1 B-ALL · Phase 1 — 50 events, n=5 ADCT-402 Ph1 B-ALL · Phase 1 — 50 events, n=4 LOTIS-3 (Lonca + Ibrutinib) · Phase 1/2 — 42 events, n=6 ADCT-402 Ph1 B-ALL · Phase 1 — 35 events, n=3 Lonca + Durvalumab (Ph1) · Phase 1 — 32 events, n=7 LOTIS-3 (Lonca + Ibrutinib) · Phase 1/2 — 31 events, n=10 Lonca + Durvalumab (Ph1) · Phase 1 — 31 events, n=3 Lonca + Durvalumab (Ph1) · Phase 1 — 29 events, n=3 LOTIS-3 (Lonca + Ibrutinib) · Phase 1/2 — 28 events, n=30 LOTIS-1 (ADCT-402 Ph1 B-NHL) · Phase 1 — 28 events, n=4 LOTIS-1 (ADCT-402 Ph1 B-NHL) · Phase 1 — 26 events, n=4 LOTIS-3 (Lonca + Ibrutinib) · Phase 1/2 — 24 events, n=4 LOTIS-2 · Approved — 23 events, n=145 ADCT-402 Ph1 B-ALL · Phase 1 — 22 events, n=5 Lonca vs Idelalisib (Ph2, terminated) · Phase 2 — 22 events, n=4 Unattributed cohort — 21 events Lonca-R, untreated DLBCL (Ph2) · Phase 2 — 17 events, n=24 LOTIS-2 · Phase 2 — 15 events, n=145 LOTIS-2 (ADCT-402-201, Phase 2) · Approved — 9 events, n=145 LOTIS-2 · Phase 2 — 8 events, n=145 LOTIS-1 (ADCT-402 Ph1 B-NHL) · Phase 1 — 8 events, n=4 Unattributed cohort — 1 event LOTIS-3 (Lonca + Ibrutinib) Phase 1/2 60 µg/kg n=37 CTCAE NR C to 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
Urinary tract infection
8.1%
Corona virus infection
— G3+ 5.4%
Pneumocystis jirovecii infection
— G3+ 2.7%
Pneumonia fungal
— G3+ 2.7%
Progressive multifocal leukoencephalopathy
— G3+ 2.7%
Urinary tract infection bacterial
— G3+ 2.7%
Clostridium difficile colitis
2.7%
Upper respiratory tract infection
2.7%
02 Construct
Molecular anatomy Linker structure C41H65N5O15
[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] copy
Payload structure C33H36N4O6
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 copy
03 Antibody
Antibody & Fc engineering Antibody
hRB4v1.2 (loncastuximab)
Epitope / domain
CD19 extracellular domain
Linker
VA dipeptide (tesirine)
Attachment
Cysteine (interchain)
Conjugation
Conventional interchain Cys
DAR homogeneity
Heterogeneous
Cleavage trigger
Cathepsin B (Val-Ala)
Release control
Conditional
Hydrophilicity mask
Discrete-PEG-spacer
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
Payload
SG3199 (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)
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.
RP2D dose
0.15 mg/kg x2 then 0.075 mg/kg
07 Pharmacology
Clinical pharmacokinetics By analyte · FDA label §12.3 + Drugs@FDA clinical-pharmacology reviews
Intact ADC Total antibody Free 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)
— — t½ 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 data status
documented-absent
Target expression in eye tissues (HCA detection · HPA bulk)
Cross-trial comparability · source-verified
Ascertainment: Symptom-driven reporting Scale: CTCAE v4 Denominator: RP2D ⚠ Not comparable: symptom-driven ascertainment
Dose & schedule → ocular toxicity · ocular AE (any-grade) by cohort
n=4 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
n=4 · LOTIS-3 (Lonca + Ibrutinib)
n=16 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
n=10 · LOTIS-3 (Lonca + Ibrutinib)
n=30 · LOTIS-3 (Lonca + Ibrutinib)
n=17 · Lonca-R, untreated DLBCL (Ph2)
n=36 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
n=19 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
n=69 · LOTIS-1 (ADCT-402 Ph1 B-NHL)
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
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