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An antibody that finds the tumour, carrying a tiny dose of very strong chemotherapy that is released only inside it.
ADCs combine a targeting antibody, a linker, and a cytotoxic payload. Third-generation ADCs (T-DXd, sacituzumab govitecan, datopotamab deruxtecan) with topoisomerase-I payloads and bystander killing have reshaped breast, lung, and urothelial cancer. Next generation: bispecific ADCs, dual payloads, degrader and immune-stimulating payloads, masked ADCs, and radio-conjugates.
ADC bioconjugation manufacturing joins a payload so toxic it needs the top containment class (OEB 5) to an antibody, then checks drug-to-antibody ratio and free payload. Capacity sits with a handful of contractors such as Lonza, WuXi XDC and Samsung Biologics, so long queues and China-based exposure shape who can develop ADCs.
An ADC payload neutraliser is an antibody given alongside an ADC that mops up the poison once it leaks into the bloodstream, so the ADC can hit the tumour with fewer side effects.
Antibody manufacturing means growing antibody drugs like pembrolizumab or trastuzumab in vats of engineered hamster cells, then purifying them. It is the industrial base for most modern cancer drugs.
An antibody-drug conjugate is an antibody that homes to a protein on the tumour cell, is swallowed, and releases a chemotherapy payload inside it. That widens chemotherapy's safe dose window about a hundredfold, which is why payloads too toxic to give alone can be used, though lung inflammation, neutropenia and eye toxicity from the payload still occur.
An ADC that carries a gene-silencing strand instead of a chemotherapy, so it can switch a protein off rather than poison the cell.
A bispecific ADC is an ADC whose antibody grabs two different proteins on the cancer cell, so it sticks better to tumour and less to healthy tissue.
An ADC that delivers a protein-destroying molecule instead of chemotherapy, hitting targets inside the cell that were previously unreachable.
After hamster cells have grown an antibody drug, the antibody has to be fished out of a soup of cells, DNA and viruses and made pure enough to inject. Purification is where much of the cost and many of the bottlenecks of biologics sit.
A dual-payload ADC is an ADC carrying two different poisons at once, so the tumour cannot escape by becoming resistant to one.
HER2 PET is a PET scan using radiolabelled trastuzumab or smaller HER2 binders to map HER2 across all metastases at once.
An immune-stimulating antibody conjugate (ISAC) is an ADC whose payload wakes up the immune system inside the tumour rather than poisoning the cell.
An ADC wearing a mask that only comes off inside the tumour, so it ignores the same protein on healthy tissue.
Payload-linker synthesis makes the cytotoxic small molecules inside ADCs (exatecan, MMAE, DM1, PBD dimers), whose occupational exposure limits sit in the nanogram range, in facilities built so a speck of dust cannot harm a worker. A handful of licensed sites such as Lonza and WuXi STA supply them, and their lead times gate hundreds of ADCs in development.
Like an ADC but with a small targeting peptide instead of an antibody, so it penetrates tumours faster and is cheaper to make.
Attaching a radioactive atom to an antibody, so an ADC's targeting is used to deliver radiation instead of chemotherapy.
Modern biologics plants grow cells in giant sterile plastic bags instead of steel tanks, throwing the bag away after each batch. It makes plants faster to build and switch, but it ties the whole industry to a few bag and filter makers.
Site-specific conjugation and linker chemistry decide exactly where and how many payloads attach to the antibody, which determines how safe and effective an ADC is.
Sterile fill-finish is putting the finished drug into vials under sterile conditions. It is a frequent cause of shortages when capacity is tight.
An antibody-drug conjugate needs three separate factories: one growing the antibody, one making the poison and its linker in sealed rooms, and one joining them. Then a fourth fills the vials. Any of the four can hold up the drug.
Topoisomerase-I inhibitors jam the enzyme that untangles DNA during copying, causing double-strand breaks. As free drugs (irinotecan, topotecan) they are modest, but their analogues SN-38 and deruxtecan are the dominant antibody-drug conjugate payload class of the 2020s, active after taxane failure; cross-resistance between these ADCs is a growing problem.
An experimental PET scan that shows whether a tumour carries the TROP2 protein, so doctors could pick the right ADC before giving it.
An option with a demonstrated survival benefit for transplant-ineligible relapsed diffuse large B-cell lymphoma, a group for whom very little has ever shown one. The fatal adverse event imbalance belongs in the conversation alongside the survival figure.
The evidence behind the United States approval of brentuximab vedotin with lenalidomide and a rituximab product for relapsed or refractory diffuse large B-cell lymphoma after two or more lines in patients not eligible for an autologous transplant or CAR-T. It is also the first demonstration that a CD30-directed conjugate helps in a disease where CD30 expression is variable.
The antibody-drug conjugate route into HER2-positive colorectal cancer, extended by DESTINY-CRC02 at a lower dose; interstitial lung disease is the class risk that defines how the drug is monitored.