Understanding the activity of antibody drug conjugates through an
evaluation of their different components
Abstract
Background and Purpose Antibody-drug conjugates (ADCs) represent a
therapeutic modality that guides chemotherapies to tumoral cells by
using antibodies against tumor associated antigens (TAAs). The antibody
and the chemotherapy or payload are attached by a chemical structure
called the linker. The strategy for the development of this type of
drugs was based on several rational pillars, including the use of a very
potent payload and the use of specific antibodies acting only on
antigens expressed on tumoral cells. Experimental Approach In this
article, by using data from all approved ADCs that have received
regulatory approval, we explore the contribution of each ADC component
to clinical activity. Key Results We have identified that the potency of
the payload and its amount -evaluated by the drug to antibody ratio
(DAR)- do not relate to clinical efficacy. Additionally, some ADCs have
been developed against antigens expressed in non-transformed tissues
producing clinical activity, suggesting that TAA specificity is not a
mandatory requirement. Finally, we observed that ADCs with payloads
harboring more favorable physicochemical characteristics showed the
greater activity, and indeed were those that used linkers with
site-specific conjugation. Conclusion and Implications Based on
currently available data, our study provides insights as to the best way
to develop novel ADCs in the future.