Antibody-drug conjugates in the treatment of breast cancer

Antibody–Drug Conjugates in Lung Cancer: Promise, Progress, and Persistent Challenges

The rationale for targeting established and emerging antigens in non-small cell and small cell lung cancer, including HER2, TROP2, c-MET, HER3, CEACAM5, DLL3, and other promising targets currently under clinical investigation are discussed.

Lipid-based nanocarrier-enabled combination therapy for breast cancer: overcoming drug resistance toward precision oncology.

Protein Nanomedicine in Breast Cancer Therapy: Targeting Strategies, Clinical Applications, and Future Perspectives

The challenges of breast cancer treatment still exist despite significant progress. The challenges include tumour heterogeneity, drug resistance and systemic toxicity. However, the development of protein nanomedicine provides a good option to address these. The present review examines the possibilities of using protein-based nanomedicine in breast cancer treatment. It looks at targeted drug delivery, immune modulation, and the mechanism of enhanced permeability and retention (EPR) for the precise targeting of the tumour. The cases refer to specific subtypes such as HER2, ER/PR positive breast cancer, and the modification of the tumour microenvironment. The small doses produced better results in terms of safety and efficiency of treatment. The examples of the medicines used include Abraxane® and Kadcyla®. The use of these medicines gives positive results in hypersensitive patients. However, there are still challenges related to regulatory approvals, immunogenicity, and scalability that should be improved.

Smart Ligand-Targeted Drug Delivery for Breast Cancer

Globally, Breast Cancer (BC) is the most common cancer to be diagnosed in women. Over the past three decades, its incidence and mortality rates have gone up as a result of improved cancer detection, changes in risk factor profiles, and improved cancer registration. Conventional breast cancer treatments can damage healthy cells and can have serious adverse effects. Therefore, novel approaches should be employed to improve overall efficacy and reduce toxic effects. Ligand-based targeting systems may be an effective strategy. To collect information, scientific databases including PubMed, ScienceDirect, ResearchGate, and the Wiley Online Library were used. All relevant data were reviewed, and a literature screening was done. High-quality studies were prioritized and summarized for citations in the review. Due to numerous side effects along with drug resistance, research in developing new strategies, including ligand-based drug delivery systems targeting breast cancers, has increased in recent years. Numerous studies have reported the development of these systems to achieve enhanced therapeutic efficacy while simultaneously reducing the drug’s unwanted side effects on healthy cells or tissues. With an emphasis on various targeting ligands, including Folic Acid (FA), carbohydrates, antibodies, peptides, transferrin, and aptamers, this article gives an overview of recent developments in targeted drug delivery systems for breast cancer treatment. The most recent instances of such tailored drug delivery systems for breast cancer are also covered in the review, along with benefits, difficulties, and potential future developments.

Application of HER2-Targeted Antibody-Drug Conjugates in the Treatment of Gastric Cancer: A Systematic Review of Pivotal Clinical Evidence

Gastric cancer ranks fifth in the world in the incidence of cancer and the fourth in mortality rate, and HER2 positive accounts for about 15%-20% of advanced gastric cancer. After the HER2 positive first-line regimen was established with trastuzumab combined chemotherapy, there was a long-term lack of standard regimens in the second and posteriary lines. Antibody-drug conjugates (ADCs) realize the accurate delivery of "antibody navigation + chemotherapy warhead" through antibody coupling of high-efficiency cytotoxic loads and dissolving connectors, and produces a bystander effect by releasing the load to penetrate the tumor microenvironment. This study retrieved the 2010-2025 PubMed, Embase and Cochrane databases according to the PRISMA process, and included a total of 15 key phase II/III trials and reviews. The results showed that the median overall survival of trastuzumab deruxtecan (T-DXd) was 3.3 months longer than ramucirumab combined with paclitaxel in the second-line phase DESTINY-Gastric04 (14.7 vs 11.4, HR 0.70), with an objective response rate of 44.3% vs 29.1%; the response rate of DESTINY-Gastric01 in Asia phase II was 51% vs chemotherapy 14%; the response rate of RC48 single-arm phase II in China's original research was 24.4%, with a median overall survival of 7.9 months. Safety is mainly manifested in about 10% of interstitial lung disease and 51% of neutrophil reduction above grade 3. This study systematically portrays the therapeutic level and adverse event spectrum of HER2-ADC, and provides evidence-based support for back-line sequential decision-making and subgroup management.

Clinical significance and safety profile of antibody-drug conjugates in malignancies of the female reproductive system

Introduction. Antibody-drug conjugates (ADCs) are expanding the therapeutic landscape of systemic treatment for malignancies of the female reproductive system, particularly in the setting of disease progression following standard chemotherapy. Their efficacy is determined by tumor target expression, antibody structure, cytotoxic payload, and drug-to-antibody ratio. However, increased selectivity of delivery does not reduce the risk of systemic and organ-specific toxicity, including adverse events affecting various organs. Aim: to synthesize data on the clinical significance and safety profile of ADCs currently used or under investigation in ovarian, endometrial, and cervical cancer, with an analysis of the frequency, clinical manifestations, mechanisms, prevention, and management of adverse events. Materials and Methods. An analytical review of publications on ADCs in gynecologic oncology was conducted, including phase I–III randomized trials, reviews, clinical guidelines, and supportive care documents. Agents targeting folate receptor alpha (FRα), tissue factor (TF), human epidermal growth factor receptor 2 (HER2), trophoblast cell surface antigen 2 (Trop-2), and cadherin-6 were analyzed. The analysis included data on molecular characteristics of the agents, antitumor activity, adverse event frequency, grade ≥ 3 toxicity, organ-specific complications, and safety monitoring approaches. Results. The most clinically significant ADCs in gynecologic oncology are mirvetuximab soravtansine, tisotumab vedotin, and trastuzumab deruxtecan; promising data have also been identified for Trop-2- and cadherin-6-targeting conjugates. Mirvetuximab soravtansine is characterized by a predominance of ocular complications, largely unrelated to FRα expression in the cornea. Tisotumab vedotin is associated with ocular toxicity, hemorrhagic complications, and peripheral neuropathy, related to tissue factor expression and microtubule-inhibiting payload. For trastuzumab  deruxtecan,  the  most  significant  toxicities  are  gastrointestinal  toxicity, myelosuppression, cardiotoxicity, and drug-induced pneumonitis. Trop-2-directed ADCs are more frequently associated with mucositis, myelosuppression, gastrointestinal disorders, and alopecia. The safety profile of each agent is determined not only by the target but also by the type of cytotoxic payload and dosing regimen. Conclusion. ADCs occupy an important position in the treatment of malignancies of the female reproductive system; however, their safe use requires individualized risk assessment, patient education, multidisciplinary monitoring, and timely dose modification. Further research should focus on identifying predictors of toxicity, optimizing preventive measures, and developing personalized ADC regimens.