Antibody–Drug Conjugates in Hematological Malignancies: Current Landscape and Future Perspectives

TL;DR

Antibody-drug conjugates (ADCs) are transforming treatment for blood cancers by delivering powerful drugs directly to cancer cells, improving outcomes and reducing side effects.

Contribution

This review provides a comprehensive overview of current ADCs for blood cancers and outlines future strategies to enhance their effectiveness.

Findings

ADCs have significantly improved the efficacy of immune-based treatments for hematological malignancies.

Optimizing antibody selectivity, linker stability, and payload potency has led to more effective ADCs reaching clinical use.

Next-generation ADCs aim to overcome current limitations and improve long-term patient prognosis.

Abstract

The therapeutic landscape for hematological malignancies has been fundamentally revolutionized over the last decade by the introduction of targeted antibodies. Notably, antibody–drug conjugates (ADCs) have emerged as a critical breakthrough, significantly improving the efficacy of immune-based treatment. ADCs function as highly sophisticated delivery systems: a selective monoclonal antibody recognizes a specific cell-surface target, guiding a potent toxic payload, attached via a chemical linker, directly into the cancer cell upon internalization. Intensive research has been dedicated to optimizing these components—improving antibody selectivity, enhancing linker stability, and utilizing highly effective payloads—which has resulted in a plethora of compounds that have reached patients’ bedsides and improved the clinical course of different tumors. This review provides a crucial overview of the current landscape of approved ADCs for hematological malignancies. It critically discusses their existing limitations and details the essential structural and chemical improvements that have yielded more potent and selective next-generation tools, finally presenting future strategies to generate highly effective “bullets” capable of decisively improving long-term disease prognosis.

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