Antibody-Drug Conjugates: A Clinical Pharmacy Perspective on an Emerging Cancer Therapy

Pharmacotherapy. 2016 Jan;36(1):99-116. doi: 10.1002/phar.1687.

Abstract

Antibody-drug conjugates (ADCs) combine highly specific monoclonal antibodies with potent cytotoxic drugs. Their synergy allows for targeted delivery of toxic drugs to cancer cells while sparing systemic exposure. In this review, we focus on the history and clinical applications of ADCs approved by the U.S. Food and Drug Administration (FDA) for the treatment of cancer and highlight new ADCs in the drug development pipeline. Three ADCs have received FDA approval thus far. Gemtuzumab ozogamicin, although withdrawn from the U.S. market, may still be an effective treatment modality in subsets of patients with acute myeloid leukemia. Brentuximab vedotin and ado-trastuzumab emtansine have shown improved efficacy and safety data compared with standard chemotherapy for the treatment of advanced lymphoma and breast cancer, respectively. With a number of ADCs with promising preliminary data in the clinical trial pipeline, cancer therapy is moving forward from traditional chemotherapy to targeted treatment modalities driven by the specificity of monoclonal antibodies and advancing biotechnology.

Keywords: Adcetris; Kadcyla; Mylotarg; ado-trastuzumab emtansine; antibody-drug conjugate; brentuximab vedotin; gemtuzumab ozogamicin.

Publication types

  • Review

MeSH terms

  • Ado-Trastuzumab Emtansine
  • Aminoglycosides / therapeutic use
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / drug therapy
  • Brentuximab Vedotin
  • Female
  • Gemtuzumab
  • Humans
  • Immunoconjugates / therapeutic use*
  • Leukemia, Myeloid, Acute / drug therapy
  • Lymphoma / drug therapy
  • Maytansine / analogs & derivatives
  • Maytansine / therapeutic use
  • Neoplasms / drug therapy*
  • Trastuzumab

Substances

  • Aminoglycosides
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Immunoconjugates
  • Maytansine
  • Brentuximab Vedotin
  • Gemtuzumab
  • Trastuzumab
  • Ado-Trastuzumab Emtansine