Work

Antibody-drug conjugates in precision oncology

Year: 2026

Type: review

Abstract: Antibody-drug conjugates (ADCs) represent a growing therapeutic class in oncology marked by several transformative clinical successes. However, these exceptional outcomes remain restricted to a limited number of tumor types, and ADC development has been marked by frequent clinical setbacks, underscoring persistent challenges in optimal patient selection, biomarker assay standardization, chemical design, and the limited predictive value of existing preclinical models. Despite broader advances in precision oncology, ADC development has largely occurred without validated biomarkers. Emerging evidence indicates that ADC activity extends beyond target antigen expression alone, encompassing tumor-intrinsic features and tumor microenvironment-dependent processes. This challenges the view of ADCs as strictly targeted agents and supports their conceptualization as tumor-ecosystem-targeting therapies governed by multidimensional biological determinants. In this review, we link ADC successes and setbacks to mechanisms of efficacy, resistance, and toxicity, and discuss how biomarkers, ADC combinations, next-generation platforms, and curative-intent strategies should shape precision oncology frameworks.

Source: Cancer Cell

DOI: 10.1016/j.ccell.2026.05.004

Authors: Barbara Pistilli, Raffaele Colombo, Maria Fernanda Mosele, Sarat Chandarlapaty

Institutions: Institut Gustave Roussy, Zymeworks (Canada), Inserm, Memorial Sloan Kettering Cancer Center

Language: English

Topic: Monoclonal and Polyclonal Antibodies Research

Subfield: Immunology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $10,400