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Antibody-Drug Conjugates (ADC): Targeted Cancer Therapy

Precision delivery of cytotoxic payloads via antibody targeting

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Antibody-Drug Conjugates (ADC): Targeted Cancer Therapy?

ADCs consist of three components: a monoclonal antibody targeting a tumor-associated antigen, a cytotoxic payload, and a chemical linker connecting them.

Approved ADCs include trastuzumab emtansine, trastuzumab deruxtecan, sacituzumab govitecan, brentuximab vedotin, polatuzumab vedotin, enfortumab vedotin and gemtuzumab ozogamicin.

The mechanism involves antigen binding, internalization, linker cleavage and release of the cytotoxic agent inside cancer cells.

Bystander effect occurs when membrane-permeable payloads diffuse from targeted cells to neighboring cells regardless of antigen expression.

Patient selection requires assessment of target expression by immunohistochemistry, fluorescence in situ hybridization or other validated methods.

Symptoms

ADCs are treatments rather than a disease; clinical effects depend on the underlying cancer being treated.
Antitumor responses include tumor shrinkage, decreased symptoms and stable disease control on imaging.
Common treatment-related side effects include fatigue, nausea, alopecia, infusion reactions and cytopenias.
Specific toxicities such as interstitial lung disease, peripheral neuropathy, ocular changes or cardiac dysfunction depend on the payload and target.
Hepatotoxicity, hematologic toxicity and infections require regular laboratory monitoring.

Risk Factors

Patient eligibility is determined by tumor type, biomarker expression, performance status and prior therapies.
Pulmonary risk factors increase concern with deruxtecan-based ADCs causing interstitial lung disease.
Pre-existing neuropathy raises caution with vedotin or emtansine-based ADCs.
Hepatic, renal or hematologic dysfunction may require dose adjustments or alternatives.
Concomitant medications with overlapping toxicities, including immunotherapy or radiation, must be considered.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New cough, dyspnea, fever or hypoxia during therapy requires urgent evaluation for interstitial lung disease.
  • Severe infusion reactions, anaphylaxis or hypersensitivity need immediate intervention.
  • Significant cytopenias with bleeding, severe infection or febrile neutropenia require prompt assessment.
  • Worsening neuropathy, severe ocular symptoms or cardiac findings warrant specialty consultation.
  • Regular surveillance with imaging, blood counts, liver and cardiac monitoring is essential during treatment cycles.

Treatment Methods

01
Drug selection follows tumor type, biomarker status, line of therapy and patient comorbidities according to clinical guidelines.
02
Dose modifications are based on toxicity grade, with delays, reductions and supportive care to optimize tolerance.
03
Premedication with corticosteroids, antihistamines and antipyretics may reduce infusion reactions.
04
Antiemetic prophylaxis, growth factor support and infection prevention are important supportive measures.
05
Combination strategies with chemotherapy, immunotherapy or targeted agents are under investigation, with novel ADCs entering clinical practice and trials offering expanded options.

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.