Antibody-drug conjugates in oncology: a clinically focused review for nursing practice

Antibody-drug conjugates (ADCs) are an expanding class of targeted cancer therapies that combine monoclonal antibody specificity with potent cytotoxic agents, offering improved precision and efficacy across multiple malignancies. As their clinical use increases, there is a growing need to address the critical role of oncology nursing in ensuring safe administration, toxicity management, and patient education.

This narrative review examines the current landscape of approved ADCs with a focus on nursing practice. It explores ADC mechanisms of action, administration considerations, and characteristic toxicity profiles, including hematologic, pulmonary, dermatologic, neurologic, and ocular adverse events. A literature search was conducted using PubMed, CINAHL, regulatory agency publications, clinical guidelines, and prescribing information, prioritizing sources published within the past decade and those relevant to clinical nursing care and patient safety.

Oncology nurses are central to the successful delivery of ADC therapy through comprehensive assessment, vigilant monitoring, proactive toxicity management, and patient education. As ADC technologies evolve and indications expand, continued development of nursing-specific protocols and education is essential to optimize patient outcomes and maintain treatment safety.