抗体药物偶联物 (ADC) 是胃癌靶向治疗的重要组成部分，有可能改变传统的治疗模式。许多ADC基于生物学理论和临床前实验已经进入严格的临床试验。还进行了与单克隆抗体疗法、化疗、免疫疗法和其他治疗相结合的模式试验，以增强药物协调作用的疗效。然而，ADC 在治疗胃癌方面表现出局限性，包括其结构或其他因素引发的耐药性。持续的深入研究和临床前实验正在取得进展，同时药物开发流程和治疗期间伴随诊断的增强也积极提高了 ADC 的功效。胃癌患者的最佳治疗策略正在不断发展。本综述总结了 ADC 治疗胃癌的临床进展，分析了 ADC 联合治疗的机制，讨论了耐药模式，并为 ADC 药物开发和伴随诊断的未来应用提供了广阔的前景。© 2024。国际胃癌协会和日本胃癌协会的独家许可。

Antibody-drug conjugates (ADCs) represent a crucial component of targeted therapies in gastric cancer, potentially altering traditional treatment paradigms. Many ADCs have entered rigorous clinical trials based on biological theories and preclinical experiments. Modality trials have also been conducted in combination with monoclonal antibody therapies, chemotherapies, immunotherapies, and other treatments to enhance the efficacy of drug coordination effects. However, ADCs exhibit limitations in treating gastric cancer, including resistance triggered by their structure or other factors. Ongoing intensive researches and preclinical experiments are yielding improvements, while enhancements in drug development processes and concomitant diagnostics during the therapeutic period actively boost ADC efficacy. The optimal treatment strategy for gastric cancer patients is continually evolving. This review summarizes the clinical progress of ADCs in treating gastric cancer, analyzes the mechanisms of ADC combination therapies, discusses resistance patterns, and offers a promising outlook for future applications in ADC drug development and companion diagnostics.© 2024. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.