Beyond the hype: Antibody-Drug Conjugates are advancing faster than our clinical strategy

Giulia Notini1,2,3,4, Giampaolo Bianchini1,2, José Manuel Perez-Garcia3,4

  • 1Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy.

Plos Medicine
|January 30, 2026
PubMed

Insights

Antibody-drug conjugates show promise for advanced breast cancer across all subtypes. Challenges remain in treatment sequencing, trial design, tolerability, and global development.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Antibody-drug conjugates (ADCs) are emerging as a significant therapeutic class in oncology.
  • ADCs demonstrate broad efficacy in advanced breast cancer, irrespective of subtype.

Purpose of the Study:

  • To review the current landscape and challenges of antibody-drug conjugates in advanced breast cancer treatment.

Main Methods:

  • Literature review of recent clinical trials and research publications on ADCs in breast cancer.
  • Analysis of current treatment guidelines and expert opinions.

Main Results:

  • ADCs show efficacy across estrogen receptor-positive, HER2-positive, and triple-negative breast cancer subtypes.
  • Key challenges include optimizing treatment sequencing, ethical clinical trial design, managing drug toxicity, and overcoming limitations of single-country studies.

Conclusions:

  • While ADCs represent a major advancement in breast cancer therapy, strategic planning is crucial for their effective and equitable implementation.
  • Addressing challenges in sequencing, trial design, tolerability, and global collaboration is essential for maximizing ADC benefits.

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