Antibody-drug conjugates (ADCs): "Smart Missiles" targeting cancer therapy

Antibody-drug conjugates (ADCs) are targeted therapeutic agents composed of monoclonal antibodies, linkers, and cytotoxic payloads. ADCs function by binding to tumor-associated antigens on cancer cells via their antibody component, forming ADC-antigen complexes. These complexes are internalized into tumor cells through endocytosis and trafficked through the endosomal-lysosomal pathway, where linkers are cleaved, releasing cytotoxic payloads to induce tumor cell apoptosis. ADCs combine the high specificity of monoclonal antibodies with the potent cytotoxicity of small-molecule drugs, enabling precise targeting of tumor cells while minimizing damage to normal tissues. This review delves into the latest advancements in antibody engineering aimed at enhancing antigen-binding efficiency, breakthroughs in novel linker designs for improving drug stability, and innovative strategies for payload optimization to augment antitumor activity. Through a comprehensive analysis of the developmental trajectory, mechanisms of action, applications, and future directions of ADCs, this review offers unique perspectives and in-depth insights to further drive innovation and clinical translation in the field of ADCs.