ADC TOXICITY ATLAS
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Indatuximab ravtansine

Discontinued
BT-062; BT062; nBT-062; nBT062-DM4
Sponsor
Biotest (Biotest Pharma GmbH / Biotest AG)
Indication
Relapsed/refractory multiple myeloma
Target family
Other
RP2D dose
160 mg/m2
Q3WPooled
01
Multi-organ toxicity

Fingerprint & organ drill-down

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

Ocular

Any-grade
6.3%
G3+
-
Pooled
sagittal schematic · Unknown

Tissues shaded by reported adverse-event rate.

Cornea
AE
3.1%
Express.
-
Limbus
AE
-
Express.
-
Conjunctiva
AE
-
Express.
-
Lens
AE
-
Express.
-
Retina / RPE
AE
-
Express.
-
Dominant tissue
Cornea
Surface subtype
Corneal (off-target)
Reversibility
Unknown
Reported ocular events
Any ocular adverse event (composite)6.3%
n=2
Corneal epithelial damage-
n=1
Corneal crystalline inclusions (corneal deposits)-
n=1
Dry eye-
n=1
Blurred vision-
n=1
02
Construct

Molecular anatomy

Antibody
IgG4
Chimeric
Linker
Cleavable
3.5
DAR
Payload
Tubulin inhibitor
Linker structureC13H14N2O4S2
[H]c1nc(SSC([H])([H])C([H])([H])C([H])([H])C(=O)ON2C(=O)C([H])([H])C([H])([H])C2=O)c([H])c([H])c1[H]
Payload structureC39H56ClN3O10S
C/C/1=C\C=C\[C@H]([C@]2(C[C@@H](C([C@H]3[C@@](O3)([C@H](CC(=O)N(C4=C(C(=CC(=C4)C1)OC)Cl)C)OC(=O)[C@H](C)N(C)C(=O)CCC(C)(C)S)C)(C)C)OC(=O)N2)O)OC
03
Antibody

Antibody & Fc engineering

Antibody
Indatuximab (nBT062)
Isotype
IgG4
Origin
Chimeric
Fc modifications
None
Glycoengineering
Standard
Effector silencing
None (native IgG4 backbone confers low effector function; no engineered silencing mutations)
FcγR binding
Retained
C1q binding
Retained
04
Linker & conjugation

Linker chemistry

Linker profile
Linker
SPDB
Class
Cleavable
Cleavage
Cleavable
Attachment
Lysine
Conjugation
Conventional Lys (SPDB)
Symmetry
Symmetric
DAR (mean)
3.5
DAR homogeneity
Heterogeneous
Plasma t½
-
Cleavage trigger
GSH/reductive (disulfide)
Release control
Conditional
Hydrophilicity mask
None
Formula
C13H14N2O4S2
Linker MW
326.399 Da
Linker TPSA
76.57 Ų
Linker xLogP
2.2093
ADCdb linker
LIN0VZYER
In-vitro stability
-
05
Payload

Payload & physicochemistry

Payload profile
Payload
DM4
Class
Maytansinoid
Mechanism
Tubulin inhibitor
Released catabolite
DM4 and S-methyl-DM4 (S-Me-DM4); primary lysosomal catabolite lysine-Nepsilon-SPDB-DM4
Mechanistic subtype
Tubulin-maytansinoid
Stereochem / salt
-
Bystander
Yes
PAMPA rank
-
MW
780.4 Da
XLogP3
3.2
logD₇.₄
3
TPSA
157 Ų
pKa
10.3 pKa
Charge pH 7.4
0
H-bond donors
3
H-bond acceptors
11
IC50 (HCEC)
-
Formula
C39H56ClN3O10S
PubChem CID
46926355
ADCdb payload
PAY0GTSVM
Hydrophobicity · logD₇.₄
hydrophilic −2+3+4 lipophilic
Bioactivity note
ADCdb DRG0AWUIJ reports tumor growth inhibition (TGI) measurements ranging 0-100% across multiple cell-line and PDX models, and clinical objective response rates of 3.20% and 5.90% depending on dosing regimen. No discrete payload IC50 listed on the ADCdb page. DM4 is a tubulin-bi
06
Dosing & regimen

Dosing

RP2D dose
160 mg/m2
Schedule
Q3W
Route
IV
Fractionated
No
n at RP2D
-
Dose basis
BSA
Trial phase
Phase 1
Dose-OAE available
No
Tox summary basis
all-doses pooled
07
Ocular & expression

Ocular profile & eye-tissue target expression

Target profile
OAE any-grade
6.3 %
OAE grade 3+
-
OAE data status
reported
Severity (weighted)
-
Keratopathy
3.1 %
Conjunctival
-
Dry eye
3.1 %
Blurred vision
3.1 %
Dominant tissue
Cornea
Surface subtype
Corneal (off-target)
Grading scale
-
Reversibility
Unknown
Target expression in eye tissues (HCA detection · HPA bulk)
Cornea (central)
-
Cornea (limbal)
-
Conjunctiva
-
RPE
-
Retina (HPA)
-
Cross-trial comparability
Ascertainment: Symptom-driven reportingScale: UnknownDenominator: RP2D⚠ OAE rate not directly comparable across trials
08
Identity & registry

Identifiers, registry & notes

ADC id
indatuximab-ravtansine
Approval status
Discontinued
Approval year
-
UniProt
P18827
ADCdb ADC
DRG0AWUIJ
ADCdb antibody
ANI0OXDFY
ADCdb target
TAR0SERWS
Primary source
Kelly et al. Clin Lymphoma Myeloma Leuk 2019;19(6):372-380 (PMID 30930134) [monotherapy/ocular]; Eaton et al. ADC ocular-AE review 2015 (PMC4677113) [ocular]; Kelly et al. Lancet Haematol 2021 (NCT01638936) [combination]
Aliases & development codes
BT-062; BT062; nBT-062; nBT062-DM4
Notes
BT-062: chimeric (hinge-unmodified) human IgG4 anti-CD138/syndecan-1 antibody (nBT062, chimerized from murine B-B4) conjugated to maytansinoid DM4 via SPDB disulfide linker at random lysines; DAR 3-4 per ADCdb (3.5 used as midpoint). Program (Biotest): two monotherapy Ph1 studies pooled in Kelly CLML 2019 (n=67 total: single-dose q3w NCT00723359 n=32, MTD 160 mg/m2; multi-dose D1,8,15 q4w n=35, MTD/RP2D 140 mg/m2) PLUS Ph1/2a combination NCT01638936 (n=64; indatuximab ravtansine + low-dose dexamethasone + lenalidomide [MTD 100 mg/m2] or pomalidomide [RP2D 100 mg/m2], D1,8,15 q4w). Program terminated. OCULAR (reason for inclusion): NO aggregate ocular rate was published. Eaton 2015 (PMC4677113) and Kelly CLML 2019 describe 2 distinct patients, both at 160 mg/m2 (single-dose schedule NCT00723359): (A) a male patient with corneal epithelial damage + crystalline corneal inclusions, grade 2, 3 days after cycle 3; (B) a female patient with dry eye + blurred vision, grade 2, 4 days after cycle 4. Both events were grade 2 and 'medically significant'; reversibility/follow-up were explicitly NOT reported (per Eaton 2015). Off-target corneal toxicity typical of DM4 maytansinoids (CD138/syndecan-1 is not expressed on cornea; SPDB-DM4 class, cf. mirvetuximab/anetumab/tusamitamab/coltuximab). The ocular percentages (oae_any 6.3%, ae_corneal/dry_eye/blurred_vision 3.1% each) are DERIVED lower bounds (2 distinct pts and 1 pt per PT, against the single-dose study population N=32); the source states only counts, not rates, and the 160 mg/m2 cohort-specific rate is HIGHER because not all 32 received 160 mg/m2 (the 160 cohort N was not separately reported). oae_g3plus_pct left blank: no G3+ ocular AE was reported (both documented events were G2), but these were spontaneously-reported AEs (no prospective ophthalmologic exam of all patients), so a true 0% G3+ is not established. CTCAE version not specified in accessible sources. HEMATOLOGIC toxicity_rows are from the COMBINATION study (N=64, Lancet Haematol 2021) and are CONFOUNDED by the lenalidomide/pomalidomide + dexamethasone backbone (IMiD-driven cytopenias); NOT clean single-agent attribution -> tagged line_context >=2L (not RP2D) and excluded from the monotherapy RP2D summary slice. Monotherapy safety: 88% of AEs were grade 1-2, most common diarrhea + fatigue (no percentages published in accessible sources -> GI/Hepatic/Pulmonary/Neurologic-PN/Infusion summary rows omitted rather than fabricated). Combo ORR: +lenalidomide 71.7% (33/46), +pomalidomide 70.6% (12/17). CHEMISTRY: linker LIN0VZYER (SPDB) physchem (SMILES/formula/MW 326.399/TPSA 76.57/xLogP 2.2093) identical to the existing SPDB-DM4 DB rows. DM4 payload physchem = DB-standard maytansinoid values (tier C). linker_plasma_t_half not measured for indatuximab specifically (SPDB-DM4 class ~5.5-7 d) -> left blank. Released catabolite and cleavage mechanism are class-inferred (SPDB disulfide reductively cleaved -> DM4 / S-methyl-DM4). IgG4 isotype chosen for low effector function (Ikeda CCR 2009). Cross-ref IDs: DrugBank DB16195; PubChem SID 472423471/223370377/160671957.