ADCs for colorectal carcinoma: decoding clinical evidence for molecular design innovation

Antibody-drug conjugate (ADC) is a novel type of targeted systemic therapy that is changing the current landscape of tumor treatment. By integrating the specificity of antibodies with the cytotoxic effects of their payloads, ADCs facilitate precise tumor killing. In solid tumors such as breast cancer, non-small cell lung cancer (NSCLC), and urothelial carcinoma, ADCs have demonstrated significant efficacy with acceptable toxicity profiles. Colorectal cancer (CRC) ranks as the third most prevalent tumor globally, and there remains an unmet clinical need for targeted treatment options. The approval of T-DXd for HER2-positive (IHC3+) CRC marks ADCs' entry into this treatment arena. This article will focus on the clinical performance of ADCs and explore design considerations and future directions for ADCs in CRC. Significance statement ADCs, a targeted treatment strategy that has emerged over the past two decades, are rapidly evolving. we believe that ADCs will offer more targeted treatment options for CRC patients in the future. This review focuses on the clinical performance of ADCs and explores design considerations and future directions for ADCs in CRC. This study provides a reference for researchers to understand and learn ADC.