Antibody-Drug Conjugates: Pharmacokinetic/Pharmacodynamic Modeling, Preclinical Characterization, Clinical Studies, and Lessons Learned

Clin Pharmacokinet. 2018 Jun;57(6):687-703. doi: 10.1007/s40262-017-0619-0.

Abstract

Antibody-drug conjugates are an emerging class of biopharmaceuticals changing the landscape of targeted chemotherapy. These conjugates combine the target specificity of monoclonal antibodies with the anti-cancer activity of small-molecule therapeutics. Several antibody-drug conjugates have received approval for the treatment of various types of cancer including gemtuzumab ozogamicin (Mylotarg®), brentuximab vedotin (Adcetris®), trastuzumab emtansine (Kadcyla®), and inotuzumab ozogamicin, which recently received approval (Besponsa®). In addition to these approved therapies, there are many antibody-drug conjugates in the drug development pipeline and in clinical trials, although these fall outside the scope of this article. Understanding the pharmacokinetics and pharmacodynamics of antibody-drug conjugates and the development of pharmacokinetic/pharmacodynamic models is indispensable, albeit challenging as there are many parameters to incorporate including the disposition of the intact antibody-drug conjugate complex, the antibody, and the drug agents following their dissociation in the body. In this review, we discuss how antibody-drug conjugates progressed over time, the challenges in their development, and how our understanding of their pharmacokinetics/pharmacodynamics led to greater strides towards successful targeted therapy programs.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Ado-Trastuzumab Emtansine
  • Aminoglycosides / pharmacokinetics
  • Aminoglycosides / pharmacology
  • Animals
  • Antibodies, Monoclonal, Humanized / pharmacokinetics
  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antineoplastic Agents, Immunological / pharmacokinetics
  • Antineoplastic Agents, Immunological / pharmacology
  • Gemtuzumab
  • Humans
  • Immunoconjugates* / pharmacokinetics
  • Immunoconjugates* / pharmacology
  • Immunoconjugates* / therapeutic use
  • Inotuzumab Ozogamicin
  • Maytansine / analogs & derivatives
  • Maytansine / pharmacokinetics
  • Maytansine / pharmacology
  • Models, Biological*
  • Neoplasms / metabolism
  • Trastuzumab / pharmacokinetics
  • Trastuzumab / pharmacology

Substances

  • Aminoglycosides
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological
  • Immunoconjugates
  • Maytansine
  • Gemtuzumab
  • Trastuzumab
  • Inotuzumab Ozogamicin
  • Ado-Trastuzumab Emtansine