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Review
. 2024 Sep 2;19(17):e202400109.
doi: 10.1002/cmdc.202400109. Epub 2024 Jul 2.

The Evolution of Antibody-Drug Conjugates: Toward Accurate DAR and Multi-specificity

Wenge Dong  1 , Wanqi Wang  1 , Chan Cao  1
Affiliations
Review

The Evolution of Antibody-Drug Conjugates: Toward Accurate DAR and Multi-specificity

Wenge Dong et al. ChemMedChem. .

Abstract

Antibody-drug conjugates (ADCs) consist of antibodies, linkers and payloads. They offer targeted delivery of potent cytotoxic drugs to tumor cells, minimizing off-target effects. However, the therapeutic efficacy of ADCs is compromised by heterogeneity in the drug-to-antibody ratio (DAR), which impacts both cytotoxicity and pharmacokinetics (PK). Additionally, the emergence of drug resistance poses significant challenges to the clinical advancement of ADCs. To overcome these limitations, a variety of strategies have been developed, including the design of multi-specific drugs with accurate DAR. This review critically summarizes the current challenges faced by ADCs, categorizing key issues and evaluating various innovative solutions. We provide an in-depth analysis of the latest methodologies for achieving homogeneous DAR and explore design strategies for multi-specific drugs aimed at combating drug resistance. Our discussion offers a current perspective on the advancements made in refining ADC technologies, with an emphasis on enhancing therapeutic outcomes.

Keywords: antibody-drug conjugates; drug resistance; homogeneous DAR; multi-specific ADC.

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