Drug resistance to antibody-drug conjugates: mechanisms, challenges, and perspectives

Yajing Liu1,2, Yuwei Liu1,2, Tingting Wu1,2

  • 1Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

Insights

Antibody-drug conjugates (ADCs) offer targeted cancer therapy by linking antibodies to chemotherapy. Overcoming drug resistance is key to maximizing their therapeutic potential.

Area of Science:

  • Oncology
  • Pharmacology
  • Biotechnology

Background:

  • Antibody-drug conjugates (ADCs) represent a significant advancement in cancer treatment, merging antibody specificity with cytotoxic payloads.
  • This approach aims to improve therapeutic efficacy and reduce systemic toxicity in oncology.
  • ADCs leverage targeted delivery to enhance cancer cell killing.

Purpose of the Study:

  • To provide a comprehensive review of antibody-drug conjugate (ADC) development and clinical success.
  • To analyze mechanisms of drug resistance encountered with ADCs.
  • To propose strategies for overcoming resistance and advancing ADC therapeutics.

Main Methods:

  • Literature review of ADC structural and mechanistic foundations.
  • Analysis of clinically successful ADCs.
  • Discussion of resistance mechanisms and potential therapeutic strategies.

Main Results:

  • ADCs have demonstrated remarkable progress in cancer treatment.
  • Drug resistance, including target antigen alterations and intracellular trafficking defects, poses a significant challenge.
  • Next-generation ADCs, combination therapies, and multi-pathway targeting are promising strategies.

Conclusions:

  • Innovative approaches are crucial for overcoming ADC resistance.
  • Further development is needed to fully realize the therapeutic promise of ADCs in cancer.
  • Addressing resistance mechanisms will expand the clinical application of ADCs.

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