Table 3

Small-molecule drug effectors

Effector drugOzogamicinMMAEMaytansinoid DM1 (mertansine)Maytansinoid DM4
Origin Semi-synthetic derivative of γ-calicheamicin (Micromonospora echinospora calichensis–Actinomycete soil bacterium) Synthetic derivative of dolastatin 10 (Dolabella auricularia–Sea hare) Synthetic derivative of maytansine (Maytenus serrata–Ethiopian shrub) Synthetic derivative of maytansine (M serrata–Ethiopian shrub); DM1 with 2 additional methyl groups 
Class of
 molecule 
Enediyne-containing antibiotic Linear cytotoxic pentapeptide Ansamycin macrolide antibiotic Ansamycin macrolide antibiotic 
Mechanism of
 action 
Intercalates in the minor groove of DNA causing double-stranded breaks Binds tubulin and inhibits normal microtubule polymerization causing mitotic arrest Binds tubulin and inhibits normal microtubule polymerization causing mitotic arrest Binds tubulin and inhibits normal microtubule polymerization causing mitotic arrest 
Example ADCs (target antigen) GO (CD33) BV (CD30) Ado-trastuzumab emtansine (Her2/neu) SAR3419 (CD19) 
INO (CD22) PV (CD22) IMGN529 (CD37) BT062 (CD138) 
 Polatuzumab vedotin (CD79b)   
Major toxicities including phase 1
 study DLTs 
Thrombocytopenia (DLT); neutropenia (DLT); hepatotoxicity Thrombocytopenia (DLT); neutropenia (DLT); hyperglycemia (DLT); peripheral neuropathy; pulmonary toxicity Thrombocytopenia (DLT); hepatotoxicity;
interstitial lung disease; peripheral neuropathy 
Ocular/corneal toxicity (DLT); peripheral neuropathy (DLT); neutropenia;
thrombocytopenia 
Effector drugOzogamicinMMAEMaytansinoid DM1 (mertansine)Maytansinoid DM4
Origin Semi-synthetic derivative of γ-calicheamicin (Micromonospora echinospora calichensis–Actinomycete soil bacterium) Synthetic derivative of dolastatin 10 (Dolabella auricularia–Sea hare) Synthetic derivative of maytansine (Maytenus serrata–Ethiopian shrub) Synthetic derivative of maytansine (M serrata–Ethiopian shrub); DM1 with 2 additional methyl groups 
Class of
 molecule 
Enediyne-containing antibiotic Linear cytotoxic pentapeptide Ansamycin macrolide antibiotic Ansamycin macrolide antibiotic 
Mechanism of
 action 
Intercalates in the minor groove of DNA causing double-stranded breaks Binds tubulin and inhibits normal microtubule polymerization causing mitotic arrest Binds tubulin and inhibits normal microtubule polymerization causing mitotic arrest Binds tubulin and inhibits normal microtubule polymerization causing mitotic arrest 
Example ADCs (target antigen) GO (CD33) BV (CD30) Ado-trastuzumab emtansine (Her2/neu) SAR3419 (CD19) 
INO (CD22) PV (CD22) IMGN529 (CD37) BT062 (CD138) 
 Polatuzumab vedotin (CD79b)   
Major toxicities including phase 1
 study DLTs 
Thrombocytopenia (DLT); neutropenia (DLT); hepatotoxicity Thrombocytopenia (DLT); neutropenia (DLT); hyperglycemia (DLT); peripheral neuropathy; pulmonary toxicity Thrombocytopenia (DLT); hepatotoxicity;
interstitial lung disease; peripheral neuropathy 
Ocular/corneal toxicity (DLT); peripheral neuropathy (DLT); neutropenia;
thrombocytopenia 

DLT, dose-limiting toxicity.

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