Antibody-drug conjugates: mechanism, progress and future directions of cancer targeted therapy

Antibody-drug conjugates (ADCs) are a new type of precise therapeutic drugs that have been widely applied in the treatment of various solid tumors and hematological malignancies, especially for patients who have failed traditional treatment or developed drug resistance. ADCs are mainly composed of a targeting monoclonal antibody, a linker, and a highly effective cytotoxic drug. Through the antibody’s recognition of tumor-specific antigens, they achieve precise drug delivery and reduce systemic toxicity. However, ADCs clinical applications still face issues such as insufficient therapeutic efficacy and acquired drug resistance. Here, we summarize the structure of ADCs and focus on discussing the drug resistance situations of ADCs that have been approved by the FDA for various solid tumors. Additionally, we explore innovative strategies for the next generation of ADCs to improve the therapeutic effect of ADCs, providing insights for the development of new cancer treatment drugs using ADCs.