Advancing antibody-drug conjugates in gynecological malignancies: myth or reality?

Area of Science:

• Oncology
• Pharmacology
• Biotechnology

Background:

• Antibody-drug conjugates (ADCs) combine monoclonal antibodies with chemotherapy for targeted tumor cell killing.
• ADCs have improved outcomes in various solid and hematologic malignancies.
• Currently, no ADCs are approved for gynecological malignancies, but promising agents are emerging.

Purpose of the Study:

• To review the structural and functional aspects of ADCs.
• To analyze recent clinical development data for ADCs in gynecological cancers.
• To discuss efficacy, toxicity, resistance mechanisms, and future combinations.

Main Methods:

• Literature review of ADCs in gynecological malignancies.
• Analysis of clinical trial data for agents like mirvetuximab soravtansine and tisotumab vedotin.
• Discussion of preclinical and clinical findings.

Main Results:

• Mirvetuximab soravtansine demonstrates activity in platinum-resistant ovarian cancer, particularly with high folate-α receptor expression.
• Tisotumab vedotin shows efficacy in pre-treated cervical cancer.
• Ongoing investigations explore ADCs in ovarian, endometrial, and cervical cancers.

Conclusions:

• ADCs hold significant potential to become part of the standard of care for gynecological malignancies.
• Further research is needed to optimize ADC therapy, including combinations and overcoming resistance.
• Understanding ADC toxicities and resistance mechanisms is crucial for clinical success.