What Are Antibody-Drug Conjugates? A Targeted Approach in Cancer Care

By: David Grew MD MPH

"ADCs are essentially a smart delivery system for chemotherapy."

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As a radiation oncologist, it hits hard when patients approach the end of the road and conventional treatments stop working.  I often meet patients curious about treatments beyond traditional chemotherapy and radiation. I remember a patient with advanced lung cancer asking, “Is there a therapy that can target only the cancer and spare healthy tissue?”

Antibody-drug conjugates, or ADCs, are an exciting development in this space, designed to deliver potent therapy directly to cancer cells, potentially sparing normal tissues and minimizing side effects. Let’s dive deeper.

How ADCs Work in Cancer Treatment

ADCs are essentially a smart delivery system for chemotherapy. They combine three components: an antibody that seeks out cancer cells, a chemotherapy drug that can kill them, and a linker that holds the two together.

The antibody is designed to recognize a specific protein on the surface of cancer cells, guiding the drug directly to its target. Once the ADC is internalized by the cancer cell, the linker breaks apart, releasing the chemotherapy drug right where it is most needed.

This targeted approach allows the chemotherapy to attack tumors with precision, which can help reduce damage to healthy cells and, in some cases, lessen side effects compared with traditional chemotherapy. Some ADCs are also engineered to release the drug in a way that affects nearby cancer cells, helping treat tumors that may have a mix of cells with and without the target.

Applications and Ongoing Research

ADCs are currently approved for several types of cancer, including certain leukemias, lymphomas, breast cancer, cervical and ovarian cancers, gastrointestinal cancers, bladder cancer, and lung cancer.

Researchers are continuing to explore new targets and develop ADCs for additional cancer types. Treatment is given through IV infusion in a clinic or hospital, with schedules depending on the specific ADC and type of cancer being treated. Side effects can include fatigue, nausea, low blood counts, or organ-specific effects, so careful monitoring is essential.

Ongoing research focuses on identifying new targets, improving the safety of the drug release, and testing different chemotherapy agents to maximize effectiveness. These advances are gradually helping ADCs become a cornerstone of precision cancer care, complementing existing treatments like chemotherapy, targeted therapy, and radiation.

Moving Forward with the Potential Impact of ADCs

The development of ADCs represents a major advance in precision oncology.

For patients with lung cancer and other cancers, ADCs could provide therapies that are more personalized, more targeted, and potentially less toxic than conventional chemotherapy. By focusing treatment on cancer cells while sparing normal tissue, ADCs may improve outcomes for tumors that are difficult to treat or resistant to existing therapies.

As we continue to refine these therapies, ADCs offer a glimpse into a future where cancer treatment is smarter, more effective, and more tailored to the individual patient.

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