PerspectiveFeatureTargeted delivery for regenerative medicines: an untapped opportunity for drug conjugates

•Targeted delivery will be a key enabler towards success in regenerative medicines.•Drug conjugates have to date been primarily used in oncology.•Safety requirements are more stringent for regenerative medicines.•Modalities smaller than antibodies may be necessary for deep tissue penetration.•a SMART framework may assist in developing better linkers.

Regenerative approaches are promising avenues to effectively cure diseases rather than merely treating symptoms, but are associated with concerns around proliferation in other organs. Given that targeted delivery holds the promise of delivering a drug precisely to its desired site of action, usually with the prospect of increasing the therapeutic index, it can be considered as an essential enabler of regenerative medicines. Although significant progress has been made predominantly in oncology for the delivery of cytotoxic drugs using antibody-drug conjugates (ADCs), the physiological conditions and safety requirements for regenerative medicines are very different. Drug conjugates need to be approached differently and, we herein suggest using a broader range of homing modalities and a specific framework to develop safe linkers.