With 9.6 million deaths in 2018,
cancer represents one of the most common causes of death, both in men and women. Despite recent advances in the understanding of molecular mechanisms involved in
cancer development and progression, treatment options are still limited. Limitations of traditional
chemotherapy include the lack of selectivity and the unfavorable safety profile. The efficacy of targeted
therapies (e.g.,
tyrosine kinase inhibitors) is also limited by their
cytostatic action, which inhibits
tumor cell proliferation without inducing
tumor cell death, and by the risk of acquired resistance.
Antibody-drug conjugates (ADCs), a newly developed class of engineered anticancer drugs, consist of recombinant
monoclonal antibodies against
tumor-specific
antigens that are covalently bound to
cytotoxic agents. They have been designed to overcome the limitations of traditional
chemotherapy and targeted
therapies by combining the target selectivity of
monoclonal antibodies with the high potency of cytotoxic drugs. Currently, ADCs that have received regulatory approval include
brentuximab vedotin for CD30-positive
Hodgkin lymphoma and
trastuzumab emtansine for human
epidermal growth factor receptor 2-positive
breast cancer. However, over 80 novel ADCs are actively being investigated in preclinical studies and early-phase clinical trials. In this review, we will provide a comprehensive overview of the biological rational, efficacy and safety of ADCs as therapeutic agents against
non-small cell lung cancer and
small cell lung cancer.