China’s Contribution to the Clinical Development of Antibody-Drug Conjugates in Gynecologic Cancers: A Review

Objective: This review summarizes global advances in antibody-drug conjugate (ADC) research for the treatment of gynecologic cancers and highlights China’s rapidly evolving role in developing these agents, aiming to contextualize their growing impact on future therapeutic standards. Mechanism: ADCs represent a transformative class of targeted therapies, coupling monoclonal antibodies with potent cytotoxic payloads through linkers, thereby enabling selective drug delivery to tumor cells while minimizing systemic toxicity. Findings in Brief: Globally, ADCs such as mirvetuximab soravtansine and tisotumab vedotin have demonstrated significant clinical benefits in platinum-resistant ovarian and recurrent cervical cancers. Parallel progress in other ADCs has expanded therapeutic options across ovarian, endometrial, and cervical cancers. In China, ADC development is accelerating, with several domestically developed agents targeting folate receptor alpha, human epidermal growth factor receptor 2, trophoblast cell surface antigen 2, cadherin-6, nectin-4, B7 homolog 4, and epidermal growth factor receptor/human epidermal growth factor receptor 3 advancing into phase II and III trials. Early results show encouraging efficacy and safety, underscoring China’s emergence as a key contributor to global anticancer innovation. Nevertheless, variability in biomarker assay, regulatory differences, and future challenges related to pricing and equitable access remain important considerations. Conclusions: ADCs are redefining the treatment landscape for gynecologic cancers. China’s expanding pipeline, supported by domestic innovation and international collaboration, is poised to significantly influence future standards of care. Continued progress in clinical validation, regulatory alignment, and the development of diagnostic and reimbursement infrastructures will be essential to ensure that these novel therapies achieve meaningful and equitable global impact.