抗体药物复合物（ADCs）最近改变了多种恶性肿瘤的治疗方式，包括乳腺癌。目前已批准用于治疗不同类型乳腺癌的两种ADCs，包括HER2靶向ADCs曲妥珠单抗乙酰甲硫氨酸盐（T-DM1）和曲妥珠单抗杂合物（T-DXd），以及TROP2靶向的ADCs宿主免疫抑制因子-{扫贫单抗嗪}-。ADC的每个组成部分（抗体、链霉素、药物负载）在决定ADC的疗效和毒性谱的过程中起着关键作用，其修饰可以对临床特征产生重大改变。借鉴三十年的发展知识，目前正在对新型ADCs进行研究。一些方法包括靶向 HER2/TROP2 以外的不同抗原，或评估构建创新类型的ADCs，如双特异性 ADCs、双药物负载的 ADCs、免疫调节 ADCs、放射性核素药物共轭物和偽装 ADCs 等等。在本综述文章中，我们讨论新型ADCs的发展趋势，重点介绍这一领域中出现的机遇和挑战。版权所有 © 2023. Elsevier B.V. 出版

Antibody-drug conjugates (ADCs) have recently reshaped the treatment of several malignancies, including breast cancer. Two ADCs are currently approved for the treatment of each breast cancer subtype, including the HER2 targeted ADCs trastuzumab emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd), and the TROP2-targeted ADC sacituzumab govitecan. Each of the ADC components (antibody, linker, payload) plays a key role in determining the efficacy and toxicity profile of ADCs, and their modification can lead to major changes in the clinical profile. Leveraging the knowledge from three decades of development in the field, novel ADCs are currently being investigated. Some approaches include targeting different antigens beyond the established HER2/TROP2, or evaluating innovative constructs, such as bispecific ADCs, ADCs with dual payload, immune-modulating ADCs, radionuclide drug conjugates, and masked ADCs, among others. In this review article we discuss the evolving landscape of novel ADCs, highlighting opportunities and challenges emerging in the field.Copyright © 2023. Published by Elsevier B.V.