Reimagining Antibody-Drug Conjugates: The Rise of Novel Targets, Bispecific Antibodies and Dual Payloads

Antibody-drug conjugate (ADCs) combine cytotoxic agents with specific antibodies through chemical linkers, with the goal of delivering drugs directly to a target within a patient’s body, and offer the potential of selective treatments and a reduction in side effects. Development and interest in this area is on the rise, with a focus on oncology targets, however, there are applications beyond this, with the potential to treat inflammatory disorders, infectious diseases, and cardiovascular disease.

The history of these treatments has been a challenging one, since the approval of the first, Mylotarg® (Pfizer/Wyeth›s drug gemtuzumab ozogamicin), in 2000. Since then, the field has been limited by a small number of validated targets and a narrow range of payloads, with modest clinical success. As of mid-2025, over 3,400 ADC assets have been developed, with more than 2,300 in active development. Approximately 600 of these are in clinical stages, and 33 have received regulatory approval (1). Interest in the area has led to advancements in the technology for manufacturing ADCs, resulting in drugs with greater stability and less variability in their structure.