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Evidence and clinical implications of target antigen changes and reassessment after ADC therapy in solid tumors

Year: 2026
Type: review
Abstract: There is growing interest in whether target antigens change after antibody-drug conjugate (ADC) therapy and how well previous test results reflect the current tumor state. Several studies have reported decreased, unchanged, or increased antigen expression after treatment. These findings are often influenced by the timing and site of sampling and the variables measured, and their meaning needs to be interpreted in the context of the specific drug and treatment setting. This review examines the evidence for post-treatment target antigen reassessment using HER2, FRα, TROP2, Nectin-4, HER3, and CLDN18.2 as representative targets. It draws on studies of patient specimens and ADC mechanisms of action to discuss the relationships between antigen changes, drug sensitivity, biomarker classification, and subsequent treatment selection. Reassessment after treatment can update previous test information and provide clues to ADC response and resistance. Reduced antigen expression may affect drug recognition and delivery. Disease progression despite retained expression suggests that antibody binding, intracellular processing, and payload sensitivity also need to be considered. For treatments with antigen expression requirements, reassessment can provide updated biomarker information.
Language: English
Subfield: Oncology
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7222921361
FWCI:
Cites: 79
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Related to: 10