Clinical pharmacologic considerations for antibody-drug conjugate in gynecologic cancers

The mainstay of treatment for gynecologic cancers includes surgical debulking followed in a subset of patients by chemotherapy, radiation, hormonal therapy, and immunotherapy. In the last 10 years, antibody-drug conjugates (ADCs) have provided new therapeutic options and significant promise for the treatment of patients with recurrent gynecologic tumors.

Information for this review article was obtained by literature review on PUBMED using phrases such as 'antibody drug conjugates in gynecologic cancers,' 'FDA approval for antibody drug conjugates in gynecologic cancers,' 'tisotumab vedotin,' 'mirvetuximab soravtansine,' 'trastuzumab deruxitcan,' 'sacituzumab govitecan,' 'datopotamab deruxtecan,' and 'sacituzumab tirumotecan.'

ADCs represent a new frontier for the treatment of gynecologic malignancies. The few ADCs currently approved by the FDA for the treatment of gynecologic cancers demonstrated higher clinical activity and better tolerability when compared to standard investigator choice chemotherapy. Streamlined pathologic tissue testing of tumor samples is required for widespread use of ADCs, and future prospective studies are needed to ascertain whether ADCs can be introduced in first-line treatment for patients with advanced gynecologic malignancies.