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Targeting therapies to specific cells or areas within the body is a concept that stretches back more than a century, especially for the treatment of cancer. However, the side effects from targeted cancer chemotherapies are often associated with non-specific toxicity on healthy cells and tissues when administered systemically.
Over the past 30 years, the development of monoclonal antibody (mAb) treatments specifically targeting cancers has made it possible to fuse (or conjugate) toxic payloads to ensure localized targeting of cancers. In turn, this minimizes non-specific toxicity to the patient. While most ADCs are designed for cancer treatments, there is a number in development to treat other ailments such as arthritis.
The three components of antibody-drug conjugates are:
Antibody: This directs the payload to the target of interest, typically in the form of a mAb, but could be a smaller antibody fragment.
Payload: This is the entity or “drug” which delivers the desired therapeutic response. For most ADCs this would be a high potency or cytotoxic API.
Linker: The component which joins the antibody to the drug. These can be cleavable, meaning they are designed to separate from the antibody at the target site. Linkers can also be non-cleavable and remain linked to the antibody.