ADCs are composed of antibodies and cytotoxic drugs, conjugated by chemical linkers. They combine the abilities of mAbs and cytotoxic drugs, improving the control of drug pharmacokinetics and allowing specific drug delivery to target cells.https://www.creativebiolabs.net/antibody-drug-conjugates-production.htm

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Figure 2 Classification and mechanism of therapeutic monoclonal antibodies (mAbs). A: mAbs recognize tumor specific
antigen, bind to target tumor cells, then result in the direct cancer cells killing, or mediate antibody-dependent cellular
cytotoxicity (ADCC) by immune cells, or induce complement-directed cytotoxicity (CDC). mAbs can also inhibit tumor
progression by blocking cytokines, chemokines, toxic antigens (B) or immune checkpoint signaling pathways (C).
Radioimmunoconjugates (D) and antibody-drug conjugates (E) deliver radioisotopes or potent toxic drugs to cancer cells,
respectively. F: Bispecific antibodies bind activating antigens on immune cells with one arm and cancer cells with the other
arm, and facilitate immune effector cells towards cancer cells
Targeting the cancer cell– inhibit critical molecular that tumor survival relies on
Most of the therapeutic antibodies drug for oncological applications target a wide variety of antigens
expressed on the surface of cancer cells. To make antigens more attractive as targets for mAb therapy,
some important characteristics should be considered, such as the density and consistency of expression
of the target molecule by malignant cells, limited expression of the target molecule on physiologically
vital benign cells, lack of high levels of soluble target and limited tendency of antigen-negative tumor
variants to emerge. The ideal therapeutic target for a therapeutic antibody is expressed on the surface
of target cells but entirely absent from normal tissue.
Through data from animal model and in vivo assay, three mechanisms of therapeutic antibodies are
validated: (1) induce malignant cells apoptosis by direct transmembrane signaling; (2) kill target cells by
complement-mediated cytotoxicity (CMC); (3) depletion of target cells by antibody-dependent cellular
cytotoxicity (ADCC). Determining which of these mechanisms (Fig. 2) is the most important one for a
given mAb in a given clinical scenario remains a challenge.