Expert consensus on the clinical application of antibody‐drug conjugates in the treatment of malignant tumors (2021 edition)

Abstract

Antibody‐drug conjugates (ADCs) are targeted biological agents composed of a cytotoxic drug linked to a monoclonal antibody through a linker. The monoclonal antibody targets tumor cells and transports small‐molecule cytotoxic drugs for specific delivery and minimal off‐target side effects. It is necessary for clinicians to understand the molecular characteristics and mechanisms of ADCs. Patients' survival mainly depends on the appropriate dose and course of treatment and also on proper management of adverse reactions. This consensus provides a systematic review of commercially available ADCs and further discusses the clinical application and management of ADCs.

Reducing Clinical Trial Monitoring Resources and Costs With Remote Monitoring: Retrospective Study Comparing On-Site Versus Hybrid Monitoring

“…Remote monitoring of clinical trials is an innovative applications of medical big data technology, promoting the implementation of patient-centered digital technology for clinical trials. At present, domestic and international investigators are actively exploring the construction and standardization of remote monitoring systems [ 12 , 15 - 17 ]. However, few reports to date have examined the effectiveness of remote monitoring.…”

A comprehensive overview on antibody-drug conjugates: from the conceptualization to cancer therapy

“…As ADCs are developed to limit their exposure to healthy tissues, they are associated with quite manageable toxicities, with nausea, vomiting, diarrhea and fatigue being among the most frequent ones. Unfortunately, the large amount of data provided by several clinical trials also highlights the presence of severe toxicities (grade 3 or higher) that include peripheral neuropathy and hematotoxicity, often dose-limiting ( Masters et al, 2018 ; Professional Committee on Clinical Research of Oncology Drugs et al, 2022 ). Peripheral neuropathy includes tingling, pain in the extremities, numbness, and rarely muscle weakness and is commonly associated with ADCs carrying cleavable linkers bound to tubulin inhibitors (i.e., all ADCs loaded with MMAE) and Mirvetuximab soravtansine, carrying DM4 ( Nguyen et al, 2023 ).…”

Peripheral neuropathy associated with monomethyl auristatin E-based antibody-drug conjugates

“…Additionally, peripheral neuropathy induced by MMAE-based ADCs has several unique features that differentiate it from other neuropathies. 10 , 52 , 92 These features include (1) predominant sensory neuropathy characterized by pain, paresthesia, numbness, hypoesthesia, and hyperesthesia that may be accompanied by motor neuropathy in certain circumstances; (2) a distal, length-dependent “stocking-glove” distribution of peripheral neuropathy; (3) symmetric distribution of peripheral neuropathy lesions; (4) onset of peripheral neuropathy after administration of MMAE-based ADCs, which may be progressive and rapid; and (5) peripheral neuropathy severity increasing with dose and duration until the cessation of treatment. Identifying these diagnostic features can assist physicians in distinguishing MMAE-based ADC-induced peripheral neuropathy from other forms of neuropathy, making more accurate diagnosis and effective treatment.…”