Rare and uncommon adverse reactions of antibody-drug conjugates in advanced solid tumors and their clinical management

Antibody-drug conjugates have emerged as one of the most promising therapeutic strategies for targeted treatment of advanced solid tumors, owing to their enhanced antitumor activity and lower toxicity to normal tissues. To date, the U.S. Food and Drug Administration has approved 13 ADC drugs for clinical use. Although ADCs offer distinct advantages over traditional anticancer agents in terms of specificity and safety due to their unique molecular design, various adverse events have still been observed during clinical application, commonly including rash, nausea, vomiting, ocular toxicity, and cardiac toxicity. A comprehensive understanding of the adverse reaction profile of ADCs can help clinicians promptly identify and effectively manage related toxicities in practice. This review focuses on rare and uncommon adverse events associated with ADCs in advanced solid tumors and their clinical management strategies, covering cardiac toxicity, interstitial lung disease, ocular toxicity, hyperglycemia and diabetic ketoacidosis, and severe cutaneous adverse reactions.