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Skin effects may appear more diffuse rather than localized
10.1016/s0039-6060(96)80258-3 71 MiyazawaK.TsubouchiH.NakaD.TakahashiK.OkigakiM.ArakakiN.et al (1989)
After endocytosis into the cell, even if the ADC-linker is stable, the complex will be degraded and the drug released
When a cell over-expresses NNMT, it does two costly things at once: it burns through methyl-donor capacity, and it diverts nicotinamide away from NAD+ regeneration into an inert metabolite (1-methylnicotinamide) that gets excreted
Furthermore, both k p2 and k O2 register as the two most sensitive parameters with respect to the main effects, with k p4 also sensitive
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