Department of Oncology, Division of Medical Oncology, University of Western Ontario, London, ON N6A 5W9, Canada.
Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON N6A 5W9, Canada.
Curr Oncol. 2024 Nov 13;31(11):7088-7106. doi: 10.3390/curroncol31110522.
Antibody-drug conjugates (ADCs) are a new class of therapeutic agents designed to target specific antigens on tumor cells, combining the specificity of monoclonal antibodies with the cytotoxicity of chemotherapy agents. ADCs have been available for over a decade, but in gynecological cancers, these agents are relatively new with great promise ahead. More than 80% of ongoing trials in gynecological cancers are evaluating ADCs' safety and efficacy, of which 40% are early-phase trials. Around twenty ADCs are currently under investigation, either alone or in combination with chemotherapies or immune checkpoint inhibitors. Among them, mirvetuximab soravtansine has been recently approved by the Food and Drug Administration (FDA) in platinum-resistant ovarian cancer with high folate-α receptor expression, as a single agent or in combination. Tisotumab vedotin and trastuzumab deruxtecan are also now approved by the FDA in patients with pre-treated cervical and uterine cancers and further investigation is ongoing. Overall, the toxicity profiles of ADCs are acceptable. Ocular toxicity is one of the specific side effects of some ADCs, but most of the cases are manageable with the use of prophylactic steroids and dose adjustments. This review aims to provide an overview of the fundamental and operational features of ADCs and examine the latest and most promising data, with a particular focus on the Canadian viewpoint.
抗体药物偶联物（ADCs）是一类新型治疗药物，旨在靶向肿瘤细胞上的特定抗原，将单克隆抗体的特异性与化疗药物的细胞毒性结合在一起。ADCs 已经问世十多年，但在妇科癌症中，这些药物相对较新，具有广阔的前景。目前，妇科癌症中有 80%以上的正在进行的试验正在评估 ADC 的安全性和疗效，其中 40%是早期试验。目前正在研究约 20 种 ADC，单独或与化疗药物或免疫检查点抑制剂联合使用。其中，mirvetuximab soravtansine 最近被美国食品和药物管理局（FDA）批准用于叶酸-α受体高表达的铂耐药卵巢癌，作为单一药物或联合用药。tisotumab vedotin 和 trastuzumab deruxtecan 也被 FDA 批准用于预处理的宫颈癌和子宫癌患者，目前正在进行进一步的研究。总体而言，ADCs 的毒性特征是可以接受的。眼部毒性是一些 ADC 的特定副作用之一，但大多数情况下可以使用预防性类固醇和剂量调整来控制。本综述旨在提供 ADC 的基本和操作特性概述，并检查最新和最有前途的数据，特别关注加拿大的观点。
