Main elements of antibody-drug conjugate (ADC): Antibodies and their targets

SOCAIL MEDIA

1. Mylotarg® (gemtuzumab ozogamicin) from Wyeth/Pfizer was the first ADC to reach the market. It is composed of a recombinant humanized anti-CD33 mAb (IgG4κ antibody hP67.6) covalently attached to a calicheamicin derived payload (N-acetyl-γ-calicheamicin 1,2-dimethyl hydrazine dichloride) via a pH-sensitive hydrazone linker.

2. Adcetris® (brentuximab vedotin) from Seagen (formerly Seattle Genetics), containing a CD30-specific mAb conjugated to monomethyl auristatin E (MMAE), received FDA approval in 2011, making it the second ADC to enter the oncology market.

3. In 2013, Kadcyla® (ado-trastuzumab emtansine), developed and marketed by Genentech/Roche, revolutionized the field of ADCs by becoming the first ADC approved for the treatment of solid tumors. It is indicated as an adjuvant (after surgery) treatment for HER2+ early breast cancer in patients who previously received trastuzumab (Herceptin®) and a taxane, separately or in combination

4. Besponsa® (inotuzmab ozogamicin (Pfizer/Wyeth)) obtained FDA approval in 2017 and is directed against CD22+ B-cell acute lymphoblastic leukemia (B-ALL). The first difference lies in the mAb and thus the antigen target and cancer indication. The recombinant humanized monoclonal IgG4 antibody (G544) employed in Besponsa® is selective for CD22 expressed on B cells in all patients with mature B-ALL, and >90% of patients with precursor B-ALL. n.

5. Polivy and Padcev Polivy® is an anti-CD79b ADC developed by Genentech/Roche using a proprietary technology developed by Seagen. It is indicated in combination with bendamustine and rituximab for treatment of adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), an aggressive type of non-Hodgkin lymphoma, who have received at least two prior therapies. This indication was granted accelerated approval based on a complete response rate. Polivy® has an approximate DAR of 3.5 molecules of MMAE attached to each antibody.

Padcev®, produced and marketed by Astellas Pharma Inc. and Seagen is a Nectin4-directed ADC. It was first granted accelerated approval in 2019 for treatment of adults with locally advanced or metastatic urothelial cancer who have previously received a programmed death receptor-1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor, and a platinum-containing therapy. In 2021, this indication was granted regular approval and Padcev® was granted accelerated approval for patients which are ineligible for cisplatin-containing chemotherapy and have previously received one or more prior lines of therapy. Padcev® is comprised of a fully humanized anti-Nectin4 IgG1κ mAb (AGS-22C3) produced by mammalian (Chinese hamster ovary) cells, and has an approximate DAR of 3.8.

6 .Enhertu® (fam-trastuzumab deruxtecan-nxki), developed by Daichi Sankyo/AstraZeneca, was granted accelerated FDA approval in December 2019 for treatment of adult patients with unresectable or metastatic HER2+ breast cancer who have received two or more prior anti-HER2 based regimens. The ADC is comprised of an anti-HER2 antibody, a protease cleavable tetrapeptide-based linker, and DXd as the drug payload.

In April 2020, Trodelvy® received accelerated FDA approval for treatment of patients with locally advanced or metastatic triple-negative breast cancer (mTNBC) who have received at least two prior therapies for metastatic disease. Trodelvy® consists of a fully humanized hRS7 IgG1κ antibody targeted against TROP2 (trophoblast antigen 2) conjugated to SN-38, the active metabolite of irinotecan via an acid-sensitive hydrolysable linker called CL2A.

GlaxoSmithKline’s ADC, Blenrep® (belantamab mafodotin-blmf), is the first approved anti-BCMA (B-cell maturation antigen) therapy. It was granted accelerated FDA approval in August 2020 for treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior therapies, including an anti-CD38 mAb, a proteasome inhibitor, and an immunomodulatory agent. Blenrep® consists of an afucosylated humanized IgG1 mAb conjugated to the tubulin inhibitor, monomethyl auristatin F (MMAF) via a non-cleavable maleimidocaproyl linker. In addition to MMAF-induced apoptosis, secondary antitumor activity results from tumor cell lysis through ADCC and ADCP effector functions.

Zynlonta® (loncastuximab tesirine-lpyl) developed by ADC Therapeutics is a CD19-directed ADC indicated for treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma (DLBCL), not otherwise specified DLBCL arising from low grade lymphoma, and high-grade B-cell lymphoma. It was granted accelerated approval for medical use by the FDA in April 2021. Zynlonta® is composed of a humanized IgG1κ mAb conjugated to SG3199, a cytotoxic pyrrolobenzodiazepine (PBD) dimer alkylating agent, through a protease-cleavable valine-alanine linker.

In late September 2021, the FDA granted accelerated approval to Tivdak® (tisotumab vedotin-tftv), deeming it the most recently approved ADC on the market. Tivdak®, co-developed by Seagen and Genmab, is the first and only approved ADC indicated for treatment of adult patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy . Tivdak® is a Tissue Factor (TF) directed ADC comprised of a human anti-TF IgG1κ antibody conjugated to MMAE via the same protease-cleavable mc-vc-PABC linker construct employed in Adcetris®, Polivy®, and Padcev®. As for these previously discussed ADCs, Tivdak® carries an average of four MMAE molecules per mAb. Furthermore, in vitro studies have demonstrated that this ADC also mediates ADCP and ADCC effector functions, thus providing multimodal antitumor activity.

As ADCs have undergone clinical development, it has become clear that the rules applying to standard chemotherapy or antibody-based therapies on their own do not necessarily apply to ADCs. ADCs are modular in nature, with interchangeable components that can be altered in a strategic fashion to improve both their efficacy and toxicity profiles. 1

Reference:

1. Mol Cancer Ther (2021) 20 (5): 885–895.

Product List

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Products Name (INN Index)
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Target
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Pre-Made Telimomab Aritox Biosimilar, Whole Mab Adc, Anti-Cd5 Antibody: Anti-LEU1/T1 therapeutic antibody
telimomab aritox
NA
CD5
ADC
Pre-Made Telisotuzumab Vedotin Biosimilar, Whole Mab Adc, Anti-Met Antibody: Anti-AUTS9/DFNB97/HGFR/RCCP2/c-Met therapeutic antibody Drug Conjugate
telisotuzumab vedotin
NA
MET
Whole mAb ADC
Pre-Made Tisotumab Vedotin Biosimilar, Whole Mab Adc, Anti-F3 Antibody: Anti-CD142/TF/TFA therapeutic antibody Drug Conjugate
tisotumab vedotin
NA
F3
Whole mAb ADC
Pre-Made Trastuzumab Deruxtecan Biosimilar, Whole Mab Adc, Anti-ERBB2/HER2 Antibody: Anti-CD340/neu/MLN 19/NEU/NGL/TKR1/VSCN2/c-ERB-2/c-ERB2 therapeutic antibody Drug Conjugate
trastuzumab deruxtecan
NA
ERBB2
Whole mAb ADC
Pre-Made Trastuzumab Duocarmazine Biosimilar, Whole Mab Adc, Anti-ERBB2/HER2 Antibody: Anti-CD340/neu/MLN 19/NEU/NGL/TKR1/VSCN2/c-ERB-2/c-ERB2 therapeutic antibody Drug Conjugate
trastuzumab duocarmazine
NA
ERBB2
Whole mAb ADC
Pre-Made Trastuzumab Emtansine Biosimilar, Whole Mab Adc, Anti-ERBB2/HER2 Antibody: Anti-CD340/neu/MLN 19/NEU/NGL/TKR1/VSCN2/c-ERB-2/c-ERB2 therapeutic antibody Drug Conjugate
trastuzumab emtansine
NA
ERBB2
Whole mAb ADC
Pre-Made Tusamitamab Ravtansine Biosimilar, Whole Mab Adc, Anti-CEACAM5/CD66e Antibody: Anti-CEA therapeutic antibody Drug Conjugate
tusamitamab ravtansine
NA
CEACAM5
Whole mAb ADC
Pre-Made Upifitamab Rilsodotin Biosimilar, Whole Mab Adc, Anti-Slc34A2 Antibody: Anti-NAPI-3B/NAPI-IIb/NPTIIb/PULAM therapeutic antibody Drug Conjugate
upifitamab rilsodotin
NA
SLC34A2
Whole mAb ADC
Pre-Made Vadastuximab Talirine Biosimilar, Whole Mab Adc, Anti-Cd33 Antibody: Anti-SIGLEC-3/SIGLEC3/p67 therapeutic antibody Drug Conjugate
vadastuximab talirine
NA
CD33
Whole mAb ADC
Pre-Made Vandortuzumab Vedotin Biosimilar, Whole Mab Adc, Anti-Steap1 Antibody: Anti-PRSS24/STEAP therapeutic antibody Drug Conjugate
vandortuzumab vedotin
NA
STEAP1
Whole mAb ADC
Pre-Made Vorsetuzumab Mafodotin Biosimilar, Whole Mab Adc, Anti-CD70/CD27-L Antibody: Anti-CD27LG/LPFS3/TNFSF7/TNLG8A therapeutic antibody Drug Conjugate
vorsetuzumab mafodotin
NA
CD70
Whole mAb ADC
Pre-Made Zilovertamab Vedotin Biosimilar, Whole Mab Adc, Anti-Ror1 Antibody: Anti-NTRKR1/dJ537F10.1 therapeutic antibody Drug Conjugate
zilovertamab vedotin
NA
ROR1
Whole mAb ADC
Pre-Made Zolimomab Aritox Biosimilar, Whole Mab Adc, Anti-Cd5 Antibody: Anti-LEU1/T1 therapeutic antibody
zolimomab aritox
NA
CD5
ADC
Pre-Made Actinium (225Ac) Lintuzumab Satetraxetan Biosimilar, Whole Mab Adc, Anti-Cd33 Antibody: Anti-SIGLEC-3/SIGLEC3/p67 therapeutic antibody Drug Conjugate
actinium (225Ac) lintuzumab satetraxetan
NA
CD33
Whole mAb ADC
Pre-Made Anetumab Corixetan Biosimilar, Whole Mab Adc, Anti-Msln Antibody: Anti-MPF/SMRP therapeutic antibody Drug Conjugate
anetumab corixetan
NA
MSLN
Whole mAb ADC
Pre-Made Anetumab Ravtansine Biosimilar, Whole Mab Adc, Anti-Msln Antibody: Anti-MPF/SMRP therapeutic antibody Drug Conjugate
anetumab ravtansine
NA
MSLN
Whole mAb ADC
Pre-Made Aprutumab Ixadotin Biosimilar, Whole Mab Adc, Anti-Fgfr2 Antibody: Anti-BBDS/BEK/BFR-1/CD332/CEK3/CFD1/ECT1/JWS/K-SAM/KGFR/TK14/TK25 therapeutic antibody Drug Conjugate
aprutumab ixadotin
NA
FGFR2
Whole mAb ADC
Pre-Made Azintuxizumab Vedotin Biosimilar, Whole Mab Adc, Anti-SLAMF7/CS1 Antibody: Anti-19A/CD319/CRACC therapeutic antibody Drug Conjugate
azintuxizumab vedotin
NA
SLAMF7
Whole mAb ADC
Pre-Made Belantamab Mafodotin Biosimilar, Whole Mab Adc, Anti-Tnfrsf17 Antibody: Anti-BCM/BCMA/CD269/TNFRSF13A therapeutic antibody Drug Conjugate
belantamab mafodotin
NA
TNFRSF17
Whole mAb ADC
Pre-Made Brentuximab Vedotin Biosimilar, Whole Mab Adc, Anti-Tnfrsf8 Antibody: Anti-CD30/D1S166E/Ki-1 therapeutic antibody Drug Conjugate
brentuximab vedotin
NA
TNFRSF8
Whole mAb ADC
Pre-Made Camidanlumab Tesirine Biosimilar, Whole Mab Adc, Anti-Il2Ra Antibody: Anti-CD25/IDDM10/IL2R/IMD41/TCGFR/p55 therapeutic antibody Drug Conjugate
camidanlumab tesirine
NA
IL2RA
Whole mAb ADC
Pre-Made Cantuzumab Mertansine Biosimilar, Whole Mab Adc, Anti-Muc1 Antibody: Anti-ADMCKD/ADMCKD1/ADTKD2/CA 15-3/CD227/Ca15-3/EMA/H23AG/KL-6/MAM6/MCD/MCKD/MCKD1/SEC/X/ZD/PEM/PEMT/PUM therapeutic anti
cantuzumab mertansine
NA
MUC1
Whole mAb ADC
Pre-Made Cantuzumab Ravtansine Biosimilar, Whole Mab Adc, Anti-Muc1 Antibody: Anti-ADMCKD/ADMCKD1/ADTKD2/CA 15-3/CD227/Ca15-3/EMA/H23AG/KL-6/MAM6/MCD/MCKD/MCKD1/SEC/X/ZD/PEM/PEMT/PUM therapeutic anti
cantuzumab ravtansine
NA
MUC1
Whole mAb ADC
Pre-Made Cetuximab Sarotalocan Biosimilar, Whole Mab Adc, Anti-Egfr Antibody: Anti-ERBB/ERBB1/ERRP/HER1/NISBD2/PIG61/mENA therapeutic antibody Drug Conjugate
cetuximab sarotalocan
NA
EGFR
Whole mAb ADC
Pre-Made Clivatuzumab Tetraxetan Biosimilar, Whole Mab Adc, Anti-Muc1 Antibody: Anti-ADMCKD/ADMCKD1/ADTKD2/CA 15-3/CD227/Ca15-3/EMA/H23AG/KL-6/MAM6/MCD/MCKD/MCKD1/SEC/X/ZD/PEM/PEMT/PUM therapeutic an
clivatuzumab tetraxetan
NA
MUC1
Whole mAb ADC
Pre-Made Cofetuzumab Pelidotin Biosimilar, Whole Mab Adc, Anti-Ptk7 Antibody: Anti-CCK-4/CCK4 therapeutic antibody Drug Conjugate
cofetuzumab pelidotin
NA
PTK7
Whole mAb ADC
Pre-Made Coltuximab Ravtansine Biosimilar, Whole Mab Adc, Anti-Cd19 Antibody: Anti-B4/CVID3 therapeutic antibody Drug Conjugate
coltuximab ravtansine
NA
CD19
Whole mAb ADC
Pre-Made Dafsolimab Setaritox Biosimilar, Whole Mab Adc, Anti-Cd3E Antibody: Anti-CD3epsilon/IMD18/T3E/TCRE therapeutic antibody Drug Conjugate
dafsolimab setaritox
NA
CD3E
Whole mAb ADC
Pre-Made Datopotamab Deruxtecan Biosimilar, Whole Mab Adc, Anti-Tacstd2 Antibody: Anti-EGP-1/EGP1/GA733-1/GA7331/GP50/M1S1/TROP2 therapeutic antibody Drug Conjugate
datopotamab deruxtecan
NA
TACSTD2
Whole mAb ADC
Pre-Made Denintuzumab Mafodotin Biosimilar, Whole Mab Adc, Anti-Cd19 Antibody: Anti-B4/CVID3 therapeutic antibody Drug Conjugate
denintuzumab mafodotin
NA
CD19
Whole mAb ADC
Pre-Made Depatuxizumab Mafodotin Biosimilar, Whole Mab Adc, Anti-Egfr Antibody: Anti-ERBB/ERBB1/ERRP/HER1/NISBD2/PIG61/mENA therapeutic antibody Drug Conjugate
depatuxizumab mafodotin
NA
EGFR
Whole mAb ADC
Pre-Made Disitamab Vedotin Biosimilar, Whole Mab Adc, Anti-ERBB2/HER2 Antibody: Anti-CD340/neu/MLN 19/NEU/NGL/TKR1/VSCN2/c-ERB-2/c-ERB2 therapeutic antibody Drug Conjugate
disitamab vedotin
NA
ERBB2
Whole mAb ADC
Pre-Made Dorlimomab Aritox Biosimilar, Whole Mab Adc: Anti-40S Ribosomal Protein S18 therapeutic antibody
dorlimomab aritox
NA
40S ribosomal protein S18
ADC
Pre-Made Enapotamab Vedotin Biosimilar, Whole Mab Adc, Anti-Axl Antibody: Anti-ARK/JTK11/Tyro7/UFO therapeutic antibody Drug Conjugate
enapotamab vedotin
NA
AXL
Whole mAb ADC
Pre-Made Enfortumab Vedotin Biosimilar, Whole Mab Adc, Anti-PVRL4/NECTIN4 Antibody: Anti-EDSS1/LNIR/PRR4/nectin-4 therapeutic antibody Drug Conjugate
enfortumab vedotin
NA
PVRL4
Whole mAb ADC
Pre-Made Farletuzumab Ecteribulin Biosimilar, Whole Mab Adc, Anti-Folr1 Antibody: Anti-FBP/FOLR/FRalpha/NCFTD therapeutic antibody Drug Conjugate
farletuzumab ecteribulin
NA
FOLR1
Whole mAb ADC
Pre-Made Gemtuzumab Ozogamicin Biosimilar, Whole Mab Adc, Anti-Cd33 Antibody: Anti-SIGLEC-3/SIGLEC3/p67 therapeutic antibody Drug Conjugate
gemtuzumab ozogamicin
NA
CD33
Whole mAb ADC
Pre-Made Glembatumumab Vedotin Biosimilar, Whole Mab Adc, Anti-Gpnmb Antibody: Anti-HGFIN/NMB/PLCA3 therapeutic antibody Drug Conjugate
glembatumumab vedotin
NA
GPNMB
Whole mAb ADC
Pre-Made Grisnilimab Setaritox Biosimilar, Whole Mab Adc, Anti-Cd7 Antibody: Anti-GP40/LEU-9/TP41/Tp40 therapeutic antibody Drug Conjugate
grisnilimab setaritox
NA
CD7
Whole mAb ADC
Pre-Made Iladatuzumab Vedotin Biosimilar, Whole Mab Adc, Anti-Cd79B Antibody: Anti-AGM6/B29/IGB therapeutic antibody Drug Conjugate
iladatuzumab vedotin
NA
CD79B
Whole mAb ADC
Pre-Made Indatuximab Ravtansine Biosimilar, Whole Mab Adc, Anti-Sdc1 Antibody: Anti-CD138/SDC/SYND1/syndecan therapeutic antibody Drug Conjugate
indatuximab ravtansine
NA
SDC1
Whole mAb ADC
Pre-Made Indusatumab Vedotin Biosimilar, Whole Mab Adc, Anti-Gucy2C Antibody: Anti-DIAR6/GC-C/GUC2C/MECILIL/STAR therapeutic antibody Drug Conjugate
indusatumab vedotin
NA
GUCY2C
Whole mAb ADC
Pre-Made Inotuzumab Ozogamicin Biosimilar, Whole Mab Adc, Anti-Cd22 Antibody: Anti-SIGLEC-2/SIGLEC2 therapeutic antibody Drug Conjugate
inotuzumab ozogamicin
NA
CD22
Whole mAb ADC
Pre-Made Labetuzumab Govitecan Biosimilar, Whole Mab Adc, Anti-CEACAM5/CD66e Antibody: Anti-CEA therapeutic antibody Drug Conjugate
labetuzumab govitecan
NA
CEACAM5
Whole mAb ADC
Pre-Made Ladiratuzumab Vedotin Biosimilar, Whole Mab Adc, Anti-Slc39A6 Antibody: Anti-LIV-1/LIV1/ZIP6 therapeutic antibody Drug Conjugate
ladiratuzumab vedotin
NA
SLC39A6
Whole mAb ADC
Pre-Made Laprituximab Emtansine Biosimilar, Whole Mab Adc, Anti-Egfr Antibody: Anti-ERBB/ERBB1/ERRP/HER1/NISBD2/PIG61/mENA therapeutic antibody Drug Conjugate
laprituximab emtansine
NA
EGFR
Whole mAb ADC
Pre-Made Lifastuzumab Vedotin Biosimilar, Whole Mab Adc, Anti-Slc34A2 Antibody: Anti-NAPI-3B/NAPI-IIb/NPTIIb/PULAM therapeutic antibody Drug Conjugate
lifastuzumab vedotin
NA
SLC34A2
Whole mAb ADC
Pre-Made Loncastuximab Tesirine Biosimilar, Whole Mab Adc, Anti-Cd19 Antibody: Anti-B4/CVID3 therapeutic antibody Drug Conjugate
loncastuximab tesirine
NA
CD19
Whole mAb ADC
Pre-Made Lonigutamab Ugodotin Biosimilar, Whole Mab Adc, Anti-Igf1R Antibody: Anti-CD221/IGFIR/IGFR/JTK13 therapeutic antibody Drug Conjugate
lonigutamab ugodotin
NA
IGF1R
Whole mAb ADC
Pre-Made Lorvotuzumab Mertansine Biosimilar, Whole Mab Adc, Anti-Ncam1 Antibody: Anti-CD56/MSK39/NCAM therapeutic antibody Drug Conjugate
lorvotuzumab mertansine
NA
NCAM1
Whole mAb ADC
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Reference

1. Mol Cancer Ther (2021) 20 (5): 885–895.