Antibody-drug conjugates in breast cancer: Marching from HER2-overexpression into HER2-low

The recent decade has witnessed a vigorous prosper of antibody-drug conjugates (ADCs) in solid tumors including breast cancer. Integrating the specificity of monoclonal antibodies and potency of cytotoxic drugs, ADCs are capable of delivering cytotoxic agents directly to tumor cells and surrounding accomplices with het-erogeneous antigen expression by exerting the distinctive bystander effect. Up till now, three ADCs (T-DM1, T-DXd and SG) have attained the official approval and stepped into clinical practices in breast cancer, with numerous promising products in the pipeline. As an unprecedented breast cancer subgroup identified following solidified drug benefit, the cognitive and therapeutic paradigm of HER2-low population which was previously thought lacking definite targets and efficacious regimens has been thoroughly rewritten by ADCs, and several encouraging achievements are expected in ongoing trials. Herein, we discuss the contrived knowledge, latest advancements and future perspectives of ADCs in HER2-overexpressing and HER2-low breast cancer.

Automated summary

In the past decade, antibody-drug conjugates (ADCs) have made considerable progress in the treatment of solid tumors, including breast cancer. ADCs combine the specificity of monoclonal antibodies and the potency of cytotoxic drugs, allowing targeted delivery of cytotoxic agents to tumor cells with heterogeneous antigen expression. Three ADCs (T-DM1, T-DXd, and SG) have been approved for clinical use in breast cancer, with many promising products in development. ADCs have revolutionized the treatment paradigm for HER2-low breast cancer, which was previously considered lacking definitive targets and effective regimens. This article discusses the current knowledge, recent advancements, and future perspectives of ADCs in HER2-overexpressing and HER2-low breast cancer.