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T-DM1 and T-DXd conditional intact-ADC pharmacokinetics

Separate fixed two-compartment intact-ADC contexts with explicit exposure and drug accounting.

Postmarketing Assessment of Antibody–Drug Conjugates: Proof‐of‐Concept Using Model‐Based Meta‐Analysis and a Clinical Utility Index Approach ↗

CPT: Pharmacometrics & Systems Pharmacology

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How does T-DM1 dose change circulating drug and cumulative exposure?

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T-DM1 0.3 mg/kg, fixed cycle-1 PK

Single specified 90-minute infusion followed through day 21; fixed intact-ADC PK coefficients and zero log deviations.

0–21 day

T-DM1 0.3 mg/kg, fixed cycle-1 PK

Single specified 90-minute infusion followed through day 21; fixed intact-ADC PK coefficients and zero log deviations.

Readouts

Central conc · ng/mL
Fixed-context physical amount, concentration, rate or nonfeedback accounting quantity.
Exposure (AUC) · ng*day/mL
Fixed-context physical amount, concentration, rate or nonfeedback accounting quantity.
Accounted ADC · mg
Fixed-context physical amount, concentration, rate or nonfeedback accounting quantity.
Fixed coefficient terminal half-life · day
Fixed-matrix slow-phase half-life; not a clinical population estimate.

Study purpose

  • How do the model's key biological readouts change under t-dm1 0.3 mg/kg, fixed cycle-1 pk?

Assumptions

  • Deterministic fixed infusion histories only; no original meta-analysis fitting, sampled population, response prediction or clinical dose selection.
  • Intact ADC serum is the modeled analyte. The apparent peripheral pool is unmeasured; no receptor, payload or binding mechanism is represented.
  • T-DM1 and T-DXd use separate reported fixed PK coefficients. Fixed study-level log deviations remain zero in every preset; they are not sampled patient effects.
  • Reference body weight converts mg/kg to mg only; kinetic coefficients have no weight covariate.
  • AUC, elapsed day and eliminated amount are nonfeedback observers. Physical day-based AUC units remain unchanged under an hour display.
  • The terminal half-life readout belongs to the fixed two-compartment coefficient matrix, not a clinical population distribution.

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Simulation time
day
day
21 → 168

Time between reported samples.

day
0.025 → 1

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Biology

Separate fixed two-compartment intact-ADC contexts with explicit exposure and drug accounting.

Separate fixed two-compartment intact-ADC contexts with explicit exposure and drug accounting.

Model details

6 parameters · 5 states · 5 equations · 20 derived outputs

Classification & API access
Therapeutic
Trastuzumab emtansine (T-DM1); trastuzumab deruxtecan (T-DXd)
Modality
Antibody–drug conjugate (ADC)
Target
HER2 / ERBB2
Disease / scope
HER2-positive cancers
ParameterDefaultUnitDescription
Systemic clearancecl_l_day0.809L/dayFixed specified coefficient; separate values apply to each ADC.
Fixed study log clearance deviationeta_study_cl0—Fixed study-level log deviation, zero in all selected histories; no random individual is generated.
Fixed study log central volume deviationeta_study_vc0—Fixed study-level log deviation, zero in all selected histories; no random individual is generated.
Intercompartmental clearanceq_l_day1.12L/dayFixed specified coefficient; separate values apply to each ADC.
Central distribution volumevc_l3.283LFixed specified coefficient; separate values apply to each ADC.
Peripheral distribution volumevp_l0.748LFixed specified coefficient; separate values apply to each ADC.

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