Antibody-durg conjugate (ADC) integrates targeting and lethality, conjugating highly targeted monoclonal antibodies (mAbs) with cytotoxic anti-tumor chemotherapy drugs through specific biochemical linkers, and releasing cytotoxic drugs to tumors through "targeted chemotherapy", giving full play to the lethality of chemotherapy drugs.
Image source: ADCREVIEW
There are two main ways for ADC to exert anti-tumor activity: one is that the specific mAb binds to the targeted cell surface antigen, is internalized by tumor cells and processed by the endolysosomal system, and the payload is released to the cytoplasm, and finally induces apoptosis through the cytotoxic pathway, and the other is to induce tumor cell death through bystander killing effect.
Global ADC Drug Progress
At the end of 2022, 15 ADC drugs have been approved for marketing worldwide, namely Pfizer's Mylotarg, Besponsa, Roche's Kadcyla, Polivy, AstraZeneca's Lumoxiti, Enhertu, Seagen/Takeda Pharmaceutical's Adcetris, Seagen/Ansetera's Padcev, Seagen/Genmab's Tivdak, GlaxoSmithKline's Blenrep. Gilead's Trodelvy, Rakuten Medical's Akalux, ADCTherapeutics' Zynlonta, Remegen's Edishi, and Elahere, approved by ImmunoGen/Huadong Pharma on November 15, 2022, treat diseases such as lymphoma, leukemia, breast cancer, multiple myeloma, breast cancer, head and neck cancer, and urothelial cancer.
Data source: Global marketing approval of WuRong Cloud
Domestic ADC drug market
There are five ADC drugs approved in the Chinese market, namely Enmetrastuzumab approved by Roche in March 2020, Verbutuximab approved by Seagen/Takeda in May 2020, vedicitumab approved by Remegen Biologics in June 2021, Augaituzumab approved by Pfizer in December 2021, and gorsatuzumab approved by Immunomedics in November 2022, and its therapeutic areas cover multiple therapeutic areas such as hematological tumors and solid tumors. It is mainly used for the treatment of advanced, recurrent/refractory and metastatic tumors.
Guidelines for ADC drugs/consensus
01 Expert consensus on the clinical application of antibody drug conjugates in the treatment of malignant tumors (2020 edition)
Citation format: Chinese Anti-Cancer Association Clinical Research Professional Committee of Cancer Drugs, National Antitumor Drug Clinical Application Monitoring Expert Committee, National Cancer Quality Control Center Breast Cancer Expert Committee, etc. Expert consensus on the clinical application of antibody-drug conjugates in the treatment of malignant tumors(2020 edition)[J].Chinese Journal of Medical Frontiers (Electronic Edition),2021,13(1):1-15.)
02 Expert consensus on safety management of breast cancer antibody drug conjugates in China (2022)
Citation format: Breast Cancer Group, Oncologist Branch of Chinese Medical Doctor Association, International Medical Exchange Branch of Chinese Anti-Cancer Association. Expert consensus on safety management of breast cancer antibody drug conjugates in China[J]. Chinese Journal of Oncology, 2022, 44(9):913-927.
03 Safety consensus on clinical application of urothelial carcinoma antibody conjugate drugs (1st edition)
Citation format: Urology Health Promotion Branch of China Association for the Promotion and Exchange of International Healthcare Care, Urology Professional Committee of China Research Hospital Association. Safety consensus on clinical application of urothelial carcinoma antibody conjugate drugs (1st edition)[J].Journal of Modern Urology,2022,27(8):628-634.)
04 Chinese expert consensus on interdisciplinary management of antibody-conjugate drug safety
Citation format: Clinical Chemotherapy Committee of Cancer of Chinese Anti-Cancer Association, Hospital Pharmacy Professional Committee of Chinese Pharmaceutical Association. Chinese expert consensus on interdisciplinary management of antibody-conjugate drug safety[J/OL].Chinese Journal of Hospital Pharmacy:1-13[2023-01-12].
http://kns.cnki.net/kcms/detail/42.1204.R.20221021.1916.004.html.
05 Guidelines for Pharmacy of Antibody Antitumor Drugs (2022)
Original download:
http://www.clponline.cn/d/file/p/2022/12-22/c631a2de32e547f15822116ba4464ab5.pdf
Editor-in-charge| Ahia
Reviewer| Ye Wenjie