抗体-药物联合物（ADCs）代表一类新颖且不断发展的抗癌药物，由单克隆抗体与生物活性药物相连，将细胞毒性化合物传递到肿瘤部位，降低全身暴露和毒性的可能性。它们通常耐受较好，然而一些可预测的不良反应需要仔细监测和及时处理。这些反应包括中性粒细胞减少症、恶心和呕吐、脱发、腹泻、左室功能不全、ILD/肺炎。本文总结了导致药物相关毒性的机制，并根据现有文献提出了预防方案和适当的管理策略。本综述旨在收集关于已批准或处于临床研究中（晚期）ADCs对乳腺癌治疗可能发生的毒性的最新证据。一个重点专注于监测方案和临床管理，旨在预防和/或及时解决相关问题，以避免过早停药或不适当剂量减少。© 2023 作者。

Antibody-drug conjugates (ADCs) represent a novel and evolving class of antineoplastic agents, constituted by monoclonal antibody linked to biologically active drugs, delivering cytotoxic compounds at the tumor site, reducing the likelihood of systemic exposure and toxicity. They are generally well tolerated, nevertheless some predictable adverse reactions need careful monitoring and timely approach. These include neutropenia, nausea and vomiting, alopecia, diarrhea, left ventricular dysfunction, ILD/pneumonitis. The mechanisms leading to drug-associated toxicities are summarized, and prophylaxis protocols and appropriate management strategies are proposed, based on current literature. This review aims to collect the most updated evidence on toxicities potentially occurring during breast cancer treatment with approved or under clinical investigation (advanced stage) ADCs. A focus is dedicated to monitoring protocols and clinical management, aimed at preventing and/or promptly address relevant problems, in order to avoid premature discontinuation or improper dose reduction.© 2023 The Author(s).