How ADCs Are Redefining Chemotherapy in Breast Cancer Care

Antibody-drug conjugates (ADCs) are changing how treatment is delivered for patients with breast cancer, according to Dr. Paolo Tarantino. Unlike traditional chemotherapy, which spreads throughout the body and clears quickly, ADCs are designed to deliver treatment directly to tumor cells.

ADCs may also help reactivate the immune system against cancer, according to Tarantino.

“I really think of ADCs as complex therapeutics with many layers of activity that we still don't fully understand,” he said in an interview with CURE at the 24th Annual International Congress on the Future of Breast Cancer® East.

Clinical studies suggest ADCs are more effective than traditional chemotherapy, especially in metastatic disease. Researchers are hopeful these therapies could also help cure more patients in the early-stage setting.

Tarantino is a breast medical oncologist at Dana-Farber Cancer Institute and Harvard Medical School, both located in Boston, Massachusetts, as well as a clinical researcher at the European Institute of Oncology, in Milan, Italy.

Transcript

How do ADCs work, and what makes them different from traditional chemotherapy?

ADCs take chemotherapy to the next level. They basically deliver it in a targeted way. Once you inject the ADC, the antibody part looks for tumor cells that overexpress a certain target. After binding to this target, the ADC can internalize and deliver the chemotherapy into the tumor cell. At the same time, it also acts as a reservoir of chemotherapy.

If you think of chemotherapy as a small molecule, when you inject it into the body, most of it is gone after a few hours. But if you bind it to an antibody, it remains in circulation for days. This allows chemotherapy to be more targeted and prolonged in its action with just one injection. Besides that, ADCs also reignite the immune system against tumor cells through the antibody.

I really think of ADCs as complex therapeutics with many layers of activity that we still don't fully understand. But overall, clinical data show that they’re much more active than chemotherapy, which is why they're raising hope to extend overall survival for patients with metastatic disease and to cure more patients in the early-stage setting.

A lot is unfolding these days. A lot is still to come. Stay tuned, because with the Annual ESMO Congress [coming up] this year, the San Antonio Breast Cancer Conference and the 2026 ASCO Annual Meeting next year, there's going to be a lot of ADCs.

Transcript has been edited for clarity and conciseness.

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