International Journal of Clinical and Pharmaceutical Innovations

An International Peer Reviewed Open Access Journal

ISSN (Online): 3142-8665
CODEN (USA): IJCPSM

editor@ijcpi.com

International Journal of Clinical and Pharmaceutical Innovations

An International Peer Reviewed Open Access Journal

ISSN (Online): 3142-8665
CODEN (USA): IJCPSM

editor@ijcpi.com

ANTIBODY-DRUG CONJUGATES IN BREAST CANCER: BENCH TO BEDSIDE INSIGHTS ON MECHANISM, EFFICACY, AND SAFETY

Pooja Kumari, Kunwar Aditi, *Dr. Najiya Fatima
Full Article DOI

Abstract

Antibody Drug Conjugates (ADCs) are a novel type of chemotherapy that treats breast cancer. It has three components where monoclonal antibodies are combined with cytotoxic payloads via a linker mechanism. In comparison with other conventional approaches, the latter approach is highly dependent upon high specificity and selectivity, which makes it suitable for addressing the needs of breast cancer therapy. Antibody drug conjugates (ADCs) focusing on HER2 and TROP-2 antigens have been developed to overcome the needs regarding breast cancer therapy. A comprehensive literature review was conducted by analyzing the PubMed/Medline, Scopus, and ClinicalTrials.gov databases to collect information on clinical trials, regulation, and translational medicine related to ADCs. Other sources have been explored to become acquainted with FDA-approved ADCs, new therapies, toxicities, and management, along with mechanisms of chemo resistance in breast cancer therapy. This article discusses information about FDA-approved ADCs, emerging therapies, toxicities, and mechanisms of therapy resistance in breast cancer. Precision oncology in breast cancer treatment has been proven due to the absence of side effects, up to now. To enhance their applicability and efficacy, further research is necessary in the case of their molecular structure and combinations.

References

  • Xiong X, Zheng LW, Ding Y, Chen YF, Cai YW, Wang LP, et al. Breast cancer: pathogenesis and treatments. Signal Transduct Target Ther., 2025; 10: 49. doi:10.1038/s41392-024-02108-4.
  • Monteiro M, Nunes N, Junior A, Fede A, Bretas G, Souza C, et al. Antibody-Drug Conjugates in Breast Cancer: A Comprehensive Review of How to Selectively Deliver Payloads. Breast cancer (Dove Med Press)., 2024; 16: 51-70. doi:10.2147/BCTT.S448191
  • Precision for Medicine. Clinical trial trends: antibody-drug conjugates [Internet]. 2024. Available from: https://www.precisionformedicine.com/blog/clinical-trial-trends-antibody-drug-conjugates  
  • Shastry M, Gupta A, Chandarlapaty S, Young M, Powles T, Hamilton E. Rise of antibody-drug conjugates: The present and future. American Society of Clinical Oncology Educational Book, 2023 May 1; 43. doi:10.1200/EDBK_390094   
  • Ruan D, Wu H, Meng Q, Xu R. Development of antibody‐drug conjugates in cancer: overview and prospects. Cancer communications, 2024 Dec 30; 44(1): 3–22. doi:10.1002/cac2.12517. 
  • Novotech. Antibody–drug conjugates: Global clinical trial landscape (2024) [Internet]. 2024 Apr 19 [cited 2026 Jan 27]. Available from: https://novotech-cro.com  
  • Larose ÉA, Hua X, Yu S, Pillai AT, Yi Z, Yu H. Antibody-drug conjugates in breast cancer treatment: resistance mechanisms and the role of therapeutic sequencing. Cancer Drug Resist, 2025 Mar 6; 8: 11. doi: 10.20517/cdr.2024.180.  
  • Takakura T, Shimizu T, Yamamoto N. Antibody-drug conjugates in solid tumors; new strategy for cancer therapy. Jpn J Clin Oncol, 2024; 54(8):     837-846. doi:10.1093/jjco/hyae054.
  • Long R, Zuo H, Tang G, Zhang C, Yue X, Yang J, et al. Antibody-drug conjugates in cancer therapy: applications and future advances. Frontiers in Immunology, 2025 May 21; 16. doi:10.3389/fimmu.2025.1516419 
  • Chen B, Zheng X, Wu J, Chen G, Yu J, Xu Y, et al. Antibody–drug conjugates in cancer therapy: current landscape, challenges, and future directions. Mol Cancer, 2025 Nov 3; 24: 279. doi:10.1186/s12943-025-02489-2.
  • Wang J, Wu SG. Breast Cancer: An Overview of Current Therapeutic Strategies, Challenges, and Perspectives. Breast Cancer (Dove Med Press), 2023 Oct 20; 15: 721-730. doi: 10.2147/BCTT.S432526.  
  • Teama H, Elnewishy A, Noureldin M, Elnewishy O. Comparative efficacy and safety of antibody-drug conjugates versus standard chemotherapy in metastatic breast cancer: a comprehensive systematic review and meta-analysis. Cureus., 2025; 17(12): e98924. doi:10.7759/cureus.98924.
  • Li X, Zhang X, Yin S, Nie J. Challenges and prospects in HER2-positive breast cancer-targeted therapy. Crit Rev Oncol Hematol, 2025; 207: 104624. doi:10.1016/j.critrevonc.2025.104624.
  • Dri A, Arpino G, Bianchini G, Curigliano G, Danesi R, De Laurentiis M, et al. Breaking barriers in triple negative breast cancer (TNBC) – Unleashing the power of antibody-drug conjugates (ADCs). Cancer Treatment Reviews, 2024 Feb 1; 123: 102672. doi:10.1016/j.ctrv.2023.102672  
  • Nagayama A, Vidula N, Ellisen L, Bardia A. Novel antibody-drug conjugates for triple negative breast cancer. Ther Adv Med Oncol, 2020 May 11; 12: 1758835920915980. doi: 10.1177/1758835920915980.
  • Liu K, Li M, Li Y, Li Y, Chen Z, Tang Y, et al. A review of the clinical efficacy of FDA-approved antibody‒drug conjugates in human cancers. Mol cancer, 2024 Mar 23; 23(1): 62. doi:10.1186/s12943-024-01963-7. 
  • Jang H, Chang JE. Strategic combinations of antibody-drug conjugates from 2023 to 2025: from dual therapies to innovative ADC-based regimens. Pharmaceutics, 2025; 17(12): 1581. doi:10.3390/pharmaceutics17121581
  • Gupta S, Singhal M, Nag S, Abbas W, Doval DC, Goyal H, et al. Safety and efficacy assessment of trastuzumab emtansine in Indian patients with HER2-positive unresectable locally advanced or metastatic breast cancer previously treated with trastuzumab and a taxane: an open-label, single-arm, phase IV study. Asia Pac J Clin Oncol, 2026; 22(2): 240-250. doi:10.1111/ajco.70007. 
  • Hurwitz J, Haggstrom L, Lim E. Antibody–Drug Conjugates: Ushering in a New Era of Cancer Therapy. Pharmaceutics, 2023 Jul 26; 15(8): 2017. doi: 10.3390/pharmaceutics15082017.
  • Patel P, Giordano A, Giordano S, Schlam I, Tolaney SM, Tarantino P. Antibody-drug conjugates for treating early-stage breast cancer: current use, anticipated evolutions. NPJ Breast Cancer, 2025 Jul 30; 11: 81. doi:10.1038/s41523-025-00800-4 
  • Center for Drug Evaluation and Research. FDA approves ado-trastuzumab emtansine for early breast cancer [Internet]. Silver Spring (MD): U.S. Food and Drug Administration.; 2019 [cited 2026 Jan 27]. Available from: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-ado-trastuzumab-emtansine-early-breast-cancer  
  • Gupta A, Sansar B, Mishra BK, Khan A, Singh A, Upadhyay A, et al. Real-world data on trastuzumab emtansine (T-DM1) efficacy and safety: results of a single-centre retrospective study of HER2-positive metastatic breast cancer patients. Sci Rep., 2025; 15(1): 18669. doi:10.1038/s41598-025-97923-2
  • U.S. Food and Drug Administration. ENHERTU (fam-trastuzumab deruxtecan-nxki) for injection: prescribing information [Internet]. Silver Spring (MD): U.S. Food and Drug Administration; 2021 Jan [cited 2026 Jan 27]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/761139s028lbl.pdf
  • U.S. Food and Drug Administration. FDA approves fam-trastuzumab deruxtecan-nxki with pertuzumab for unresectable or metastatic HER2-positive breast cancer [Internet]. Silver Spring (MD): U.S. Food and Drug Administration [cited 2026 Jan 28]. Available from: https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-fam-trastuzumab-deruxtecan-nxki-pertuzumab-unresectable-or-metastatic-her2-positive   
  • Mobashir M, Tarique H, Habib I, Ahmad S, Inam A, Qamar I, et al. Datopotamab deruxtecan: a new era in targeted therapy for metastatic breast cancer. Annals of Medicine & Surgery, 2025 Sep 12; 87: 6942-6943. doi: 10.1097/MS9.0000000000003857  
  • U.S. Food and Drug Administration. FDA approves datopotamab deruxtecan-dlnk for unresectable or metastatic, HR-positive, HER2-negative breast cancer [Internet]. Silver Spring (MD): U.S. Food and Drug Administration; 2025 Jan 17 [cited 2026 Jan 27]. Available from: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-datopotamab-deruxtecan-dlnk-unresectable-or-metastatic-hr-positive-her2-negative-breast
  • Tolaney SM, DeMichele A, Takano T, Rugo HS, Perou C, Lynce F, et al. OptimICE-RD: sacituzumab govitecan + pembrolizumab vs pembrolizumab (± capecitabine) for residual triple-negative breast cancer; Future Oncol, 2024; 20(31): 2343-2355. doi:10.1080/14796694.2024.2357534.
  • Manna M, Brabant M, Greene R, Chamberlain MD, Kumar A, Alimohamed N, et al. Canadian Expert Recommendations on Safety Overview and Toxicity Management Strategies for Sacituzumab Govitecan Based on Use in Metastatic Triple-Negative Breast Cancer. Current Oncology, 2024; 31(9): 5694-5708. https://doi.org/10.3390/curroncol31090422   
  • U.S. Food and Drug Administration. FDA grants regular approval to sacituzumab govitecan for triple-negative breast cancer [Internet]. Silver Spring (MD): U.S. Food and Drug Administration; 2021 Apr 7 [cited 2026 Jan 28]. Available from: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-regular-approval-sacituzumab-govitecan-triple-negative-breast-cancer   
  • U.S. Food and Drug Administration. FDA approves sacituzumab govitecan-hziy for HR-positive breast cancer [Internet]. Silver Spring (MD): U.S. Food and Drug Administration; 2023 Feb 3 [cited 2026 Jan 28]. Available from: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-sacituzumab-govitecan-hziy-hr-positive-breast-cancer   
  • Drago JZ, Modi S, Chandarlapaty S. Unlocking the potential of antibody-drug conjugates for cancer therapy. Nat Rev Clin Oncol, 2021 Jun; 18(6):        327-344. doi: 10.1038/s41571-021-00470-8. 
  • Kang S, Kim SB. Toxicities and management strategies of emerging antibody-drug conjugates in breast cancer. Ther Adv Med Oncol, 2025 Mar 24; 17: 17588359251324889. doi: 10.1177/17588359251324889 
  • Shimizu T, Sands J, Yoh K, Spira AI, Garon EB, Kitazono S, et al. First-in-Human, Phase I Dose-Escalation and Dose-Expansion Study of Trophoblast Cell-Surface Antigen 2–Directed Antibody-Drug Conjugate Datopotamab Deruxtecan in Non–Small-Cell Lung Cancer: TROPION-PanTumor01. Journal of Clinical Oncology, 2023 Oct 10; 41(29): 4678–4687. doi:10.1200/JCO.23.00059.
  • Nguyen TD, Bordeau BM, Balthasar JP. Mechanisms of ADC Toxicity and Strategies to Increase ADC Tolerability. Cancers (Basel), 2023 Jan 24; 15(3): 713. doi:10.3390/cancers15030713.
  • ClinicalTrials.gov. A phase II, open-label study to evaluate the efficacy and safety of trastuzumab deruxtecan (T-DXd) for the treatment of unresectable and/or metastatic solid tumors harboring HER2 activating mutations regardless of tumor histology [Internet]. Bethesda (MD): U.S. National Library of Medicine; 2020 [cited 2026 Jan 27]. Identifier: NCT04639219. Available from: https://www.astrazenecaclinicaltrials.com/study/D967MC00001/
  • Cheng Y, Lu J, Zhang C, Yan W, Zhu P, Qin Q, Gong L. Overview of antibody-drug conjugates nonclinical and clinical toxicities and related contributing factors. Antib Ther., 2025 Mar 18; 8(2): 124-144. doi: 10.1093/abt/tbaf004
  • D'Arienzo A, Verrazzo A, Pagliuca M, Napolitano F, Parola S, Viggiani M, et al. Toxicity profile of antibody-drug conjugates in breast cancer: practical considerations. E Clinical Medicine, 2023; 62: 102113. doi:10.1016/j.eclinm.2023.102113.
  • Peddi PF, Hurvitz SA. Ado-trastuzumab emtansine (T-DM1) in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer: latest evidence and clinical potential. Ther Adv Med Oncol, 2014 Sep; 6(5): 202-9. doi: 10.1177/1758834014539183. 
  • Spring LM, Nakajima E, Hutchinson J, Viscosi E, Blouin G, Weekes C, et al. Sacituzumab govitecan for metastatic triple-negative breast cancer: clinical overview and management of potential toxicities. Oncologist, 2021; 26(10): 827-834. doi:10.1002/onco.13878
  • Hu Y, Zhu Y, Qi D, Tang C, Zhang W. Trop2-targeted therapy in breast cancer. Biomarker Res., 2024; 12(1): 82. doi:10.1186/s40364-024-00633-6.
  • Iqbal N, Iqbal N. Human epidermal growth factor receptor 2 (HER2) in cancers: overexpression and therapeutic implications. Mol Biol Int., 2014; 2014: 852748. doi:10.1155/2014/852748.
  • Yamazaki CM, Yamaguchi A, Anami Y, et al. Antibody-drug conjugates with dual payloads for combating breast tumor heterogeneity and drug resistance. Nat Commun., 2021; 12: 3528. doi:10.1038/s41467-021-23793-7.
  • Chang HL, Schwettmann B, McArthur HL, Chan IS. Antibody-drug conjugates in breast cancer: overcoming resistance and boosting immune response. J Clin Invest., 2023 Sep 15; 133(18): e172156. doi:10.1172/JCI172156
  • Chen N, Michaels E, Howard F, Nanda R. The evolving therapeutic landscape of antibody-drug conjugates in breast cancer. Expert Rev Anticancer Ther., 2022; 22(12): 1325-1331. doi:10.1080/14737140.2022.2147510.
  • Davis AA, Hesse J, Pereira PMR, Ma CX. Novel treatment approaches utilizing antibody-drug conjugates in breast cancer. NPJ Breast Cancer, 2025; 11(1): 42. doi:10.1038/s41523-025-00743-w.
  • Xing M, Li Z, Cui Y, He M, Xing Y, Yang L, et al. Antibody-drug conjugates for breast cancer: a bibliometric study and clinical trial analysis. Discov Oncol, 2024; 15(1): 329. doi:10.1007/s12672-024-01192-w.

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Citation

1Pooja Kumari, 2Kunwar Aditi, 3*Dr. Najiya Fatima. (2026). Antibody-Drug Conjugates In Breast Cancer: Bench To Bedside Insights On Mechanism, Efficacy, And Safety. International Journal of Clinical and Pharmaceutical Innovations, 1(7), 36-48.

Keywords

Antibody-drug conjugates, Breast cancer, HER2, TROP-2, Drug resistance, Precision oncology.