ReviewPost screenAdvances in antibody-drug conjugates: A new era of targeted cancer therapy

•ADC represents a new class of targeted anticancer therapeutics.•Elucidates selection criteria for tumor specific antigen and ADC development.•Smart linkers and fixed DAR value for reducing side effects of ADCs are covered.•Current clinical trial trends and market prediction of ADCs are summarized.

Antibody-drug conjugates (ADCs), a potent class of anticancer therapeutics, comprise a high-affinity antibody (Ab) and cytotoxic payload coupled via a suitable linker for selective tumor cell killing. In the initial phase of their development, two ADCs, Mylotarg®, and Adcetris® were approved by the US Food and Drug Administration (FDA) for treating hematological cancer, but the real breakthrough came with the discovery of the breast cancer-targeting ADC, Kadcyla®. With advances in bioengineering, linker chemistry, and potent cytotoxic payload, ADC technology has become a more powerful tool for targeted cancer therapy. In addition, ADCs with improved safety using humanized Abs with a unified 'drug:antibody ratio' (DAR) have been achieved. Concomitantly, there has been a significant increase in the number of clinical trials with anticancer ADCs with high translation potential.