Clinical application and optimization strategies for antibody-drug conjugates in solid tumors

Despite the availability of multiple treatments for solid tumors, the prognosis of advanced solid tumors remains poor. Antibody-drug conjugates, a novel type of antitumor drugs, which are created by conjugating cytotoxic small-molecule drugs with monoclonal antibodies using well-designed linkers, can selectively deliver effective cytotoxic drugs to tumor cells. Currently, antibody-drug conjugates targeting multiple therapeutic targets for solid tumors are being constantly developed, optimized, and improved, opening up a broad-spectrum antitumor treatment model. However, the use of antibody-drug conjugates is still associated with some limitations that need to be urgently overcome such as poor permeability in solid tumors, notable toxic adverse reactions, and drug resistance. This review mainly discusses the functionality, iteration history, and research progress regarding the use of antibody-drug conjugates in the treatment of common solid tumors and explores possible optimization strategies for the future based on their toxicity, efficacy, and drug resistance, which will ultimately benefit more patients with cancer.