# Antibody–drug conjugates in colorectal cancer: advances in targeted delivery and personalized oncology

**Authors:** Huanle Wang, Xueyan Yan, Cong Xia, Danni Chen, Bo Pan, Yinan Zhang, Qianshi Zhang

PMC · DOI: 10.3389/fbioe.2026.1756741 · Frontiers in Bioengineering and Biotechnology · 2026-02-12

## TL;DR

Antibody-drug conjugates (ADCs) offer a promising approach for targeted and personalized treatment of colorectal cancer.

## Contribution

The paper reviews recent advances in ADC design and their potential for precision therapy in colorectal cancer.

## Key findings

- ADCs combine specific antibody targeting with cytotoxic drugs to improve treatment efficacy.
- Challenges such as resistance and toxicity remain barriers to ADC success in colorectal cancer.
- Multidisciplinary collaboration is needed to advance ADCs into effective personalized therapies.

## Abstract

Colorectal cancer remains among the most prevalent gastrointestinal malignancies worldwide, imposing a substantial clinical burden and highlighting the urgent need for precision and personalized treatment strategies. Conventional drug delivery approaches are limited by low selectivity, restricted bioavailability, and systemic toxicity, thereby limiting therapeutic efficacy. Antibody–drug conjugates, as advanced delivery plat-forms, have the advantages of highly specific antibody recognition, versatile cytotoxic payloads, and continuously evolving linker technologies. This combination provides novel opportunities to increase efficacy, reduce toxicity, and enable individualized precision therapy. Recent advances have demonstrated the potential of ADCs in CRC, yet challenges such as resistance, toxicity, and clinical translation persist. Multidisciplinary efforts among the pharmaceutical industry and molecular biology and clinical medicine fields will be essential to accelerate the development of more precise and personalized CRC therapies. This review summarizes the current research progress on ADCs as a treatment option for CRC, discusses innovations in delivery system design, examines the key challenges of personalization, and highlights future directions to better integrate ADCs into effective treatment paradigms.

## Linked entities

- **Diseases:** colorectal cancer (MONDO:0005575)

## Full-text entities

- **Genes:** BRAF (B-Raf proto-oncogene, serine/threonine kinase) [NCBI Gene 673] {aka B-RAF1, B-raf, BRAF-1, BRAF1, NS7, RAFB1}, STING1 (stimulator of interferon response cGAMP interactor 1) [NCBI Gene 340061] {aka ERIS, MITA, MPYS, NET23, SAVI, STING}, GUCY2C (guanylate cyclase 2C) [NCBI Gene 2984] {aka DIAR6, GC-C, GCC, GUC2C, HSER, MECIL}, CDKN1A (cyclin dependent kinase inhibitor 1A) [NCBI Gene 1026] {aka CAP20, CDKN1, CIP1, MDA-6, P21, SDI1}, CLDN6 (claudin 6) [NCBI Gene 9074], PTEN (phosphatase and tensin homolog) [NCBI Gene 5728] {aka 10q23del, BZS, CWS1, DEC, GLM2, MHAM}, IFNB1 (interferon beta 1) [NCBI Gene 3456] {aka IFB, IFF, IFN-beta, IFNB}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, ADAM9 (ADAM metallopeptidase domain 9) [NCBI Gene 8754] {aka CORD9, MCMP, MDC9, Mltng}, PTK2B (protein tyrosine kinase 2 beta) [NCBI Gene 2185] {aka CADTK, CAKB, FADK2, FAK2, PKB, PTK}, GOLM1 (golgi membrane protein 1) [NCBI Gene 51280] {aka C9orf155, GOLPH2, GP73, HEL46, PSEC0257, bA379P1.3}, PTK7 (protein tyrosine kinase 7 (inactive)) [NCBI Gene 5754] {aka CCK-4, CCK4}, EGFR (epidermal growth factor receptor) [NCBI Gene 1956] {aka ERBB, ERBB1, ERRP, HER1, NISBD2, NNCIS}, WNT3 (Wnt family member 3) [NCBI Gene 7473] {aka INT4, TETAMS}, NRAS (NRAS proto-oncogene, GTPase) [NCBI Gene 4893] {aka ALPS4, CMNS, N-ras, NCMS, NRAS1, NS6}, Cav1 (caveolin 1, caveolae protein) [NCBI Gene 12389] {aka Cav, Cav-1}, ZHX2 (zinc fingers and homeoboxes 2) [NCBI Gene 22882] {aka AFR1, RAF}, LGR5 (leucine rich repeat containing G protein-coupled receptor 5) [NCBI Gene 8549] {aka FEX, GPR49, GPR67, GRP49, HG38}, ERBB2 (erb-b2 receptor tyrosine kinase 2) [NCBI Gene 2064] {aka CD340, HER-2, HER-2/neu, HER2, MLN 19, MLN-19}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, GSK3B (glycogen synthase kinase 3 beta) [NCBI Gene 2932], NECTIN4 (nectin cell adhesion molecule 4) [NCBI Gene 81607] {aka EDSS1, LNIR, PRR4, PVRL4, nectin-4}, ABCG2 (ATP binding cassette subfamily G member 2 (JR blood group)) [NCBI Gene 9429] {aka ABC15, ABCP, BCRP, BMDP, CD338, CDw338}, TNFRSF10B (TNF receptor superfamily member 10b) [NCBI Gene 8795] {aka CD262, DR5, KILLER, KILLER/DR5, TRAIL-R2, TRAILR2}, AZIN2 (antizyme inhibitor 2) [NCBI Gene 113451] {aka ADC, AZIB1, ODC-p, ODC1L, ODCp}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) [NCBI Gene 5290] {aka CCM4, CLAPO, CLOVE, CWS5, HMH, MCAP}, ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, Erbb2 (erb-b2 receptor tyrosine kinase 2) [NCBI Gene 13866] {aka Erbb-2, HER-2, HER2, Neu, c-erbB2, c-neu}, PDCD1 (programmed cell death 1) [NCBI Gene 5133] {aka ADMIO4, AIMTBS, CD279, PD-1, PD1, SLEB2}, TNC (tenascin C) [NCBI Gene 3371] {aka 150-225, DFNA56, GMEM, GP, HXB, JI}, CLDN1 (claudin 1) [NCBI Gene 9076] {aka CLD1, ILVASC, SEMP1}, SLC46A3 (solute carrier family 46 member 3) [NCBI Gene 283537] {aka FKSG16}, MET (MET proto-oncogene, receptor tyrosine kinase) [NCBI Gene 4233] {aka AUTS9, DA11, DFNB97, HGFR, RCCP2, c-Met}, KRAS (KRAS proto-oncogene, GTPase) [NCBI Gene 3845] {aka 'C-K-RAS, C-K-RAS, CFC2, K-RAS2A, K-RAS2B, K-RAS4A}, LGALS3BP (galectin 3 binding protein) [NCBI Gene 3959] {aka 90K, BTBD17B, CyCAP, M2BP, MAC-2-BP, TANGO10B}, CGAS (cyclic GMP-AMP synthase) [NCBI Gene 115004] {aka C6orf150, D4, MB21D1, h-cGAS}, CTNNB1 (catenin beta 1) [NCBI Gene 1499] {aka CTNNB, EVR7, MRD19, NEDSDV, armadillo}, ABCC2 (ATP binding cassette subfamily C member 2) [NCBI Gene 1244] {aka ABC30, CMOAT, DJS, MRP2, cMRP}, DNER (delta/notch like EGF repeat containing) [NCBI Gene 92737] {aka UNQ26, bet}, TACSTD2 (tumor associated calcium signal transducer 2) [NCBI Gene 4070] {aka EGP-1, EGP1, GA733-1, GA7331, GP50, M1S1}, MAPK1 (mitogen-activated protein kinase 1) [NCBI Gene 5594] {aka ERK, ERK-2, ERK2, ERT1, MAPK2, NS13}, CDCP1 (CUB domain containing protein 1) [NCBI Gene 64866] {aka CD318, SIMA135, TRASK}, TOP2A (DNA topoisomerase II alpha) [NCBI Gene 7153] {aka TOP2, TOP2alpha, TOPIIA, TP2A}, EREG (epiregulin) [NCBI Gene 2069] {aka EPR, ER, Ep}, Sh3gl1 (SH3-domain GRB2-like 1) [NCBI Gene 20405] {aka EEN, SH3P8, Sh3d2b}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, ERBB3 (erb-b2 receptor tyrosine kinase 3) [NCBI Gene 2065] {aka ErbB-3, FERLK, HER3, LCCS2, MDA-BF-1, VSCN1}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, CEACAM6 (CEA cell adhesion molecule 6) [NCBI Gene 4680] {aka CD66c, CEAL, NCA, NCA-50/90}, MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, ATP2A2 (ATPase sarcoplasmic/endoplasmic reticulum Ca2+ transporting 2) [NCBI Gene 488] {aka ATP2B, DAR, DD, RHABDO2, SERCA2}, CDH17 (cadherin 17) [NCBI Gene 1015] {aka CDH16, HPT-1, HPT1}, FCGRT (Fc gamma receptor and transporter) [NCBI Gene 2217] {aka FCRN, FcgammaRn, alpha-chain}, TOP1 (DNA topoisomerase I) [NCBI Gene 7150] {aka TOPI}, BCL2L1 (BCL2 like 1) [NCBI Gene 598] {aka BCL-XL/S, BCL2L, BCLX, Bcl-X, PPP1R52}, CEACAM5 (CEA cell adhesion molecule 5) [NCBI Gene 1048] {aka CD66e, CEA}
- **Diseases:** Cardiotoxicity (MESH:D066126), sarcoma (MESH:D012509), glioblastoma (MESH:D005909), bladder cancer (MESH:D001749), Non-small-cell lung cancer (MESH:D002289), solid (MESH:D018250), hepatic tumour (MESH:D008113), hypoxia (MESH:D000860), radiation enteritis (MESH:D004751), gallbladder cancer (MESH:D005706), gastric cancer (MESH:D013274), B-cell lymphoma-extra large (MESH:D016393), amplified breast cancer (MESH:D001943), hypoxic (MESH:D002534), anaemia (MESH:D000743), gastrointestinal malignancies (MESH:D005770), hepatic toxicities (MESH:D056486), peripheral neuropathy (MESH:D010523), ADCs (MESH:D009759), ILD (MESH:D017563), diarrhea (MESH:D003967), ocular toxicity (MESH:D000081028), non-Hodgkin lymphoma (MESH:D008228), pneumonitis (MESH:D011014), CDC (MESH:D019966), fibrosarcoma (MESH:D005354), neurotoxic (MESH:D020258), gastrointestinal toxicities (MESH:D005767), cancer (MESH:D009369), MSI-H (MESH:D053842), Lysosomal dysfunction (MESH:D016464), weight loss (MESH:D015431), GI adverse (MESH:D064420), DM1 (MESH:D009223), rectal cancer (MESH:D012004), gastrointestinal symptoms (MESH:D012817), lung metastasis (MESH:D009362), haematologic toxicities (MESH:D006402), ADCC (MESH:D007153), Neutropenia (MESH:D009503), keratopathy (MESH:C562399), Metastatic colorectal cancer (MESH:D015179), mPFS (MESH:D011475), multidrug (MESH:D018088), urothelial carcinoma (MESH:D014523), oesophageal, gastric, and pancreatic tumours (MESH:D010190)
- **Chemicals:** MMAE (MESH:C495575), gemcitabine (MESH:D000093542), ABT-414 (MESH:C000620234), guanosine (MESH:D006151), DM4 (MESH:D008453), disitamab vedotin (MESH:C000722994), docetaxel (MESH:D000077143), oxaliplatin (MESH:D000077150), bevacizumab (MESH:D000068258), DMSA (MESH:D004113), U3-1402 (MESH:C000710748), auristatin (MESH:C543533), maleimide (MESH:C043592), tislelizumab (MESH:C000707970), tyrosine (MESH:D014443), rabusertib (MESH:C582547), azobenzene (MESH:C009850), 5-fluorouracil (MESH:D005472), Trodelvy (MESH:C000608132), T-DM1 (MESH:D000080044), triptolide (MESH:C001899), hydrazones (MESH:D006835), glutathione (MESH:D005978), metformin (MESH:D008687), Peptide (MESH:D010455), Mylotarg (MESH:D000079982), DS-8201 (MESH:C000614160), cysteine (MESH:D003545), panitumumab (MESH:D000077544), abemaciclib (MESH:C000590451), pertuzumab (MESH:C485206), capecitabine (MESH:D000069287), glycan (MESH:D011134), Exatecan (MESH:C095887), depatuxizumab mafodotin (MESH:C000631685), IMMU-130 (MESH:C000624221), SN-38 (MESH:D000077146), labetuzumab (MESH:C110010), cetuximab (MESH:D000068818), trastuzumab (MESH:D000068878), MLN0264 (MESH:C000626278), amatoxins (MESH:C018207), AM1 (-), glucuronides (MESH:D020719), Duocarmycin SA (MESH:C066098), anthracycline (MESH:D018943), doxorubicin (MESH:D004317), patritumab (MESH:C585471), uridine (MESH:D014529), thioethers (MESH:D013440), PBD (MESH:C438462), disulfides (MESH:D004220), Hu3f8 (MESH:C000718263)
- **Species:** Rattus norvegicus (brown rat, species) [taxon 10116], Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]
- **Mutations:** serine/threonine, V600E
- **Cell lines:** HT-29 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0320), N87 — Homo sapiens (Human), Gastric tubular adenocarcinoma, Cancer cell line (CVCL_1603), -6 — Homo sapiens (Human), Tongue squamous cell carcinoma, Cancer cell line (CVCL_5985), RC48 — Homo sapiens (Human), Clear cell renal cell carcinoma, Cancer cell line (CVCL_6195), LS174T — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_1384), GW-39 — Homo sapiens (Human), Clear cell renal cell carcinoma, Cancer cell line (CVCL_5876), JIMT1 — Homo sapiens (Human), Breast ductal carcinoma, Cancer cell line (CVCL_2077), N87-KR — Xenopus laevis (African clawed frog), Spontaneously immortalized cell line (CVCL_VQ55), HEK293 — Homo sapiens (Human), Transformed cell line (CVCL_0045), SW480 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0546)

## Full text

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## Figures

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## References

282 references — full list in the complete paper: https://tomesphere.com/paper/PMC12936049/full.md

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Source: https://tomesphere.com/paper/PMC12936049