Schulich School of Medicine, Western University, London, ON N6A 5C1, Canada.
Division of Medical Oncology, Department of Oncology, London Health Sciences Centre, Western University, London, ON N6A 5W9, Canada.
Curr Oncol. 2023 Jul 6;30(7):6447-6461. doi: 10.3390/curroncol30070474.
Antibody-drug conjugates (ADCs) are revolutionizing cancer treatment, adding another important new class of systemic therapy. ADCs are a specially designed class of therapeutics that target cells expressing specific cancer antigens using directed antibody-drug delivery and release a cytotoxic chemotherapeutic payload. Over the past two decades, improvements in ADC design, development, and research, particularly in breast cancer, have led to several recent landmark publications. These advances have significantly changed various treatment paradigms and revamped traditional classifications of breast cancer with the introduction of a potential new subtype: "HER2-low". This review will focus on several ADCs developed for breast cancer treatment, including trastuzumab emtansine (T-DM1), trastuzumab deruxtecan (T-DXd), sacituzumab govitecan (SG) and other newer emerging agents. It will provide an overview of the role of ADCs in breast cancer and discuss the opportunities and challenges they present. Additionally, our review will discuss future research directions to improve the selection of targets, combination therapies, and aim to improve drug safety. Important first-line metastatic and adjuvant clinical trials are underway, which may expand the role of ADC therapy in breast cancer. We foresee ADCs driving a new era of breast cancer treatment, adding to the steady incremental survival advantage observed in recent years.
抗体药物偶联物 (ADC) 正在彻底改变癌症治疗，为系统治疗增添了另一个重要的新类别。ADC 是一类专门设计的治疗药物，通过靶向抗体药物输送靶向表达特定癌症抗原的细胞，并释放细胞毒性化疗有效载荷。在过去的二十年中，ADC 的设计、开发和研究取得了进展，特别是在乳腺癌方面，这导致了最近的几项具有里程碑意义的出版物。这些进展极大地改变了各种治疗模式，并通过引入潜在的新亚型“HER2-低”，彻底改变了乳腺癌的传统分类。这篇综述将重点介绍几种用于乳腺癌治疗的 ADC，包括曲妥珠单抗-美坦新偶联物（T-DM1）、曲妥珠单抗-德曲妥珠单抗（T-DXd）、Sacituzumab govitecan（SG）和其他新兴的药物。它将概述 ADC 在乳腺癌中的作用，并讨论它们带来的机遇和挑战。此外，我们的综述将讨论未来的研究方向，以改善靶点选择、联合治疗，并旨在提高药物安全性。正在进行重要的一线转移性和辅助临床试验，这可能会扩大 ADC 治疗在乳腺癌中的作用。我们预计 ADC 将推动乳腺癌治疗的新时代，为近年来观察到的稳定的生存优势增加新的动力。
