Nature: Overview and Market Forecast of Antibody Conjugate Drug Development

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In recent years, antibody-conjugated drugs (ADC) have sprung up in the oncology field.

ADC drugs approved for marketing

gemtuzumab ozogamicin (trade name: Mylotarg) was developed by Pfizer.

Vibutuximab (trade name: Adcetris) was developed by Seagen/Takeda and is an anti-CD30 mAb-methylaustatin E (MMAE) conjugate.

Two other ADCs targeting CD22 have been approved, namely Pfizer's inotuzumab ozogamicin (trade name: Besponsa) and moxetumomab pasudotox (trade name: Lumoxiti) jointly developed by AstraZeneca/Innate Pharma.

In the past two years, two new target ADCs have been approved, namely Roche’s polatuzumab vedotin (trade name: Polivy) and GlaxoSmithKline’s belantamab mafodotin (trade name: Blenrep).

Enmetrastuzumab (trade name: Kadcyla) developed by Roche is the first ADC approved for the treatment of solid tumors.

Sacituzumab govitecan (trade name: Trodelvy) developed by Gilead is an anti-TROP2 monoclonal antibody-SN-38 conjugate, approved for use in treated patients with metastatic triple-negative breast cancer.

Enfortumabvedotin (trade name: Padcev) jointly developed by Seagen/Astellas is a Nectin-4 monoclonal antibody-MMAE conjugate drug and the first ADC to enter the urothelial cancer market.

The latest ADC drug approved is cetuximab sarotalocan (trade name: Akalux) developed by RakutenMedical.

ADCs in the late stages of clinical development

Trastuzumabduocarmazine, developed by Byondis, is an ADC drug targeting HER2 and is undergoing a phase III clinical study for the treatment of HER2-positive metastatic breast cancer.

Wendixituzumab developed by Rongchang Biologics is also an anti-HER2 ADC drug, and is currently conducting phase III clinical studies for the treatment of breast cancer in China.

ImmunoGen’s Mirvetuximabsoravtansine is an antifolate receptor-α (FRα) monoclonal antibody and a highly cytotoxic drug maytansinoid DM4 conjugate.

Tisotumab vedotin was jointly developed by Seagen and Genmab.

Datopotamab deruxtecan (Daiichi Sankyo/AstraZeneca) and SAR408701 (Sanofi) are both in phase III clinical research and are developed to treat treated metastatic NSCLC.

Loncastuximabtesirine developed by ADC Therapeutics is an anti-CD19 ADC drug coupled to a dimer of pyrrolobenzodiazepines.

Camidanlumab tesirine, jointly developed by ADC Therapeutics and Genmab, is an anti-CD25 ADC drug.

Probodydrug conjugates are masked ADC drugs.
These ADC drugs are activated by proteases specifically expressed in the tumor microenvironment.
The potential advantages of this technology include protecting normal tissues expressing target antigens from ADC drugs and increasing effective drug doses in tumor tissues.
CX-2029 (CytomXTherapeutics/AbbVie) and CX-2009 (CytomX Therapeutics) are pro-antibody drug conjugates that target CD71 and CD166, respectively, and are currently in phase II clinical development.

There are also many new target ADC drugs, including LIV1 (ladiratuzumab vedotin), AXL (BA3011), and MT1-MMP (membranetype 1-matrix metalloprotease; BT1718), which are in phase II clinical development.

ADC Drug Market Forecast

The global market size of ADC drugs on the market is expected to exceed 16.
4 billion U.
S.
dollars by 2026.
Because trastuzumab deruxtecan (AstraZeneca/Daiichi Sankyo) has been approved for multiple breast cancer subgroups (HER2+, HR+/HER2- and triple negative) patients, and the treatment time is long, it is expected to be 6.
2 billion Dollar sales rank first.
Enmetrastuzumab (Roche) is limited to the treatment of HER2+ breast cancer and will face the impact of biosimilar drugs in the United States.
Its sales in 2026 are expected to be US$2.
3 billion.

Enfortumab vedotin (Seagen/Astellas) was approved for the treatment of treated metastatic urothelial cancer.
In the future, it is expected to expand its indications to a larger population of patients in the early stages of the disease course, thereby boosting its global sales by 2026 3.
5 billion US dollars.
Sacituzumab govitecan (Gilead) in breast cancer and urothelial cancer patients will bring its sales to 1.
1 billion US dollars.

Verbutuximab (Seagen/Takeda) covers several subgroups of Hodgkin's lymphoma and other hematological malignancies, with global sales reaching 1.
8 billion US dollars in 2026.
Benefiting from fewer competitors for R/R DLBCL indications and expanded indications for untreated DLBCL patients, Polatuzumab vedotin is expected to have sales of US$850 million.

In terms of multiple myeloma, belantamab mafodotin (GSK) is expected to expand the applicable population to the early stage of the disease, but may face fierce competition from existing therapies; sales in 2026 are expected to reach nearly 400 million US dollars.
Due to the small population (treated acute lymphoblastic leukemia and hairy cell leukemia), inotuzumab ozogamicin and moxetumomab pasudotox are expected to have lower sales.

As new drugs continue to enter the oncology field, the ADC drug market will achieve further growth after 2026.

references:

Nature Reviews Drug Discovery.
The oncology market for antibody-drug conjugates.