Mihaylova Rositsa, Momekova Denitsa, Elincheva Viktoria, Momekov Georgi
Department "Pharmacology, Pharmacotherapy and Toxicology", Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria.
Department "Pharmaceutical Technology and Biopharmaceutics", Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria.
Pharmaceuticals (Basel). 2024 Dec 17;17(12):1701. doi: 10.3390/ph17121701.
The present review provides a detailed and comprehensive discussion on antibody-drug conjugates (ADCs) as an evolving new modality in the current therapeutic landscape of malignant diseases. The principle concepts of targeted delivery of highly toxic agents forsaken as stand-alone drugs are examined in detail, along with the biochemical and technological tools for their successful implementation. An extensive analysis of ADCs' major components is conducted in parallel with their function and impact on the stability, efficacy, safety, and resistance profiles of the immunoconjugates. The scope of the article covers the major classes of currently validated natural compounds used as payloads, with an emphasis on their structural and mechanistic features, natural origin, and distribution. Future perspectives in ADCs' design are thoroughly explored, addressing their inherent or emerging challenges and limitations. The survey also provides a comprehensive overview of the molecular rationale for active tumor targeting of ADC-based platforms, exploring the cellular biology and clinical relevance of validated tumor markers used as a "homing" mechanism in both hematological and solid tumor malignancies.
本综述对抗体药物偶联物(ADCs)进行了详细而全面的讨论,ADCs作为恶性疾病当前治疗领域中一种不断发展的新方式。本文详细研究了将高毒性药物作为独立药物摒弃后进行靶向递送的主要概念,以及成功实现这些概念的生化和技术工具。在分析ADCs主要成分的同时,还对其功能以及对免疫偶联物的稳定性、疗效、安全性和耐药性的影响进行了广泛分析。文章范围涵盖了目前用作有效载荷的主要已验证天然化合物类别,重点介绍了它们的结构和作用机制、天然来源及分布。文中深入探讨了ADCs设计的未来前景,阐述了其固有的或新出现的挑战与局限。该综述还全面概述了基于ADCs平台实现肿瘤主动靶向的分子原理,探讨了在血液系统恶性肿瘤和实体瘤中用作“归巢”机制的已验证肿瘤标志物的细胞生物学及临床相关性。