Toxic effect | ADCs | Frequency | Possible mechanism |
---|---|---|---|
Interstitial lung disease Pneumonitis | T-Dxd [46] ARX788 [25] | Any grade: 15.5% Grade 3:1% Grade 4: 0.1% Grade 5: 2.4% Any grade: 19.6% Grade 3: 2% | Alveolar inflammation and fibrosis due to off-target activity of DXd Unknown |
LVEF drop | T-DM1 [44] T-Dxd [15] | Any grade: 2% Grade 3–4: 0.7% Any grade: 1.6% Grade 3–4: 0.5% | Target-related: morphologic and functional potentially reversible damage to cardiomyocytes inducted by anti HER2-Ab |
Prolonged QT | T-Dxd [15] | Any grade: 4.9% Grade 3–4: 1.1% | Unknown |
Ocular toxicities | SYD985 [18] A166 [19] ARX788 [25] | Conjunctivitis  All grades: 31%  Grade 3/4: 3% Keratitis:  All grades: 19%  Grade 3/4: 2% Overall and any grade: 80% Overall and any grade: 41.2 % | Systemic releasing of the payload |