Antibody-drug conjugates (ADCs) have emerged as a transformative approach in cancer therapy by enhancing tumor targeting and minimizing systemic toxicity compared to traditional chemotherapy. Initially developed with chemotherapy agents as payloads, ADCs have now incorporated alternative payloads, such as immune-stimulating agents, natural toxins, and radionuclides, to improve therapeutic efficacy and specificity. A significant advancement in ADC technology is the integration of Proteolysis Targeting Chimeras (PROTACs), which enable the precise degradation of cellular targets involved in tumorigenesis. This strategy enhances the specificity and precision of cancer therapies, addressing key mechanisms in cancer cell survival. Moreover, incorporating radioactive isotopes into ADCs is an emerging strategy aimed at further improving therapeutic outcomes. By delivering localized radiation, this approach offers the potential to enhance the efficacy of treatment and expand the therapeutic arsenal. Despite these innovations, challenges remain, including dysregulated immune activation, severe adverse effects, and intrinsic immunogenicity of some agents. These emerging issues highlight the ongoing need for optimization in ADC therapy. This review summarizes the latest developments in ADC technology, focusing on novel payloads, PROTAC integration, and the potential for combining ADCs with other therapeutic modalities to refine cancer treatment and improve patient outcomes.
Keywords: ADC; PROTAC; TLR; bacterial toxins; payloads; precision medicine.
New treatments for cancer: using antibody–drug conjugates to deliver more than just chemotherapy Antibody-drug conjugates (ADCs) are a new type of cancer treatment that can target cancer cells more precisely, reducing side effects compared to traditional chemotherapy. ADCs were first combined with chemotherapy drugs, but now they also use other treatments like immune-boosting agents, natural toxins, and even radioactive substances to make the treatment more effective. These advances allow ADCs to deliver treatment directly to cancer cells, improving the chances of success. While there are still some challenges to overcome, such as managing side effects, researchers are working on making these therapies safer and more effective. ADCs offer a more targeted approach to cancer treatment, with the potential to improve outcomes and reduce harm to healthy cells.
© The Author(s), 2025.