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Table 1 Drug conjugates approved by the FDA

From: Drug conjugates for the treatment of lung cancer: from drug discovery to clinical practice

Drug name

Drug type

Mechanism

Indication

Year of FDA approval

SGN-35

ADC

SGN-35 binds specifically to CD30-positive tumor cells and releases the cytotoxic drug MMAE within the target cells [396,397,398,399]

Hodgkin lymphoma, large cell lymphoma

2011

T-DM1

ADC

T-DM1 retains the effect of trastuzumab and inhibits HER2 receptor signaling while inducing antibody-dependent cell-mediated cytotoxicity (ADCC) and inhibiting HER2 extracellular domain shedding in HER2-overexpressing human breast cancer cells [400, 401]

Breast cancer

2013

Inotuzumab ozogamicin

ADC

When the antibody binds to the CD22 receptor on the surface of B cells, the drug exerts a strong cytotoxic effect on CD22+ B-cell lymphoma [402,403,404,405]

Acute lymphoblastic leukemia

2017

Moxetumomab pasudotox

ADC

Internalization of moxetumumab pasudotox-tdfk leads to ribosylation of extension factor 2 ADP, inhibition of protein synthesis and apoptotic cell death [406,407,408,409]

Relapsed or refractory hairy cell leukemia

2018

Polatuzumab vedotin

ADC

Chemotherapy drugs bind specifically to the protein CD79b on the surface of B cells and release it into the B cells, thereby inhibiting cell division and inducing cell apoptosis [137, 410,411,412]

Diffuse large B-cell lymphoma

2019

Enfortumab

vedotin

ADC

The anticancer activity of enfortumab vedotin-ejfv is due to the binding of the ADC to cells expressing Nectin-4, subsequent internalization of the ADC-Nectin-4 complex, and release of MMAE through proteolytic cleavage [270, 413,414,415,416,417,418]

Urothelial cancer

2019

T-DXd

ADC

T-DXd connects antibodies and chemotherapeutic drugs through special connectors. The antibody part can accurately locate cancer cells, deliver the chemotherapeutic drugs to the cancer cells, and accurately kill cancer cells. At the same time, it can kill adjacent tumor cells through transmembrane action [419,420,421,422]

Breast cancer

2019

Sacituzumab govitecan

ADC

Sacituzumab govitecan can deliver chemotherapeutic drugs directly to the tumor cell microenvironment by combining antibodies with TROP-2 antigen expressed on most breast cancer cells [423,424,425,426,427]

Triple-negative breast cancer

2020

Belantamab mafodotin

ADC

Belantamab mafodotin blmf exerts antitumor activity on multiple myeloma cells. It can kill tumor cells through MMAF-induced apoptosis, antibody-dependent cytotoxicity (ADCC) and antibody-dependent phagocytosis (ADCP) [73, 428,429,430,431,432]

Relapsed or refractory multiple myeloma

2020

Cetuximab saratolacan

ADC

Cetuximab saratolacan can bind to the epidermal growth factor receptor on the surface of tumor cells, prevent the receptor from binding to other ligands, inhibit the activity of tyrosine kinases, and reduce the transmission of proliferation signals to tumor cells [433]

Head and neck cancer

2020

Gemtuzumab ozogamicin

ADC

Gemtuzumab ozogamicin is a CD33 antibody drug conjugate (ADC) that, when combined with other enhanced chemotherapy regimens, can reduce disease recurrence and increase the survival of AML patients [50, 434,435,436,437,438]

Acute myeloid leukemia

2020

Loncastuximab tesirine-lpyl

ADC

When loncastuximab binds to CD19, the linker is degraded by proteases and releases SG3199 within tumor cells. The released SG3199 can bind to small DNA grooves, forming highly cytotoxic DNA strand cross-linking, which subsequently induces tumor cell death [436, 439,440,441]

Large B-cell lymphoma

2021

RC48

ADC

RC48 targets HER2 antigen on the surface of tumor cells, accurately identifying and killing tumor cells, and can cause widespread antigen release to other metastatic lesions [442,443,444]

HER2+ gastric carcinoma

2021

Tisotumab vedotin-tftv

ADC

Tisotumab vedotin-tftv is the first TF-guided ADC 1 that works by binding to TFs expressed on solid tumors [445,446,447]

Cervical cancer

2021

MIRV

ADC

MIRV enters tumor cells through endocytosis by binding to FRa on the surface of the tumor cell membrane, releases the anti-microtubule drug DM4 under the action of enzymes in tumor cells, and induces cell cycle arrest and apoptosis by inhibiting tubulin polymerization and microtubule aggregation [59, 70, 448,449,450,451]

Ovarian cancer

2022

111In-DTPA-octreotide

RDC

Octreotide is as a tumor-targeting peptide targeting the somatostatin (SST) receptor, and 111In is a payload that chelates with diethylene triaminopentaacetic acid [452, 453]

Diagnosis of SSTR-positive tumors

1994

99mTc-EDDA

RDC

99mTc-EDDA can be directly used for thyroid imaging or can react with a variety of chelating agents to produce different SPECT imaging agents for different nuclear medicine examination items [454,455,456]

Diagnostic thyroid imaging

2013

68Ga-DOTATATE

RDC

68Ga DOTATATE is a positron emission tomography (PET) radioactive tracer targeting somatostatin receptor type 2, which has been proven to be a reliable biomarker for meningioma [457,458,459,460]

Detection of neuroendocrine cancer

2016

177Lu DOTATATE

RDC

177Lu DOTATATE is a radiation therapy drug that works by binding to specific tumor-expressed somatostatin receptors. After binding to the receptor, the drug enters the cell and causes radiation damage to the tumor cells [461, 462]

Diagnosis of neuroendocrine cancer

2018

Detectnet

RDC

Detectnet is a positron emission tomography (PET) agent suitable for locating somatostatin receptor-positive neuroendocrine tumors (NETs) in adult patients

Diagnosis of neuroendocrine cancer

2020

68 Ga-DOTATOC

RDC

Somatostatin receptor II has become the main target for imaging and treatment of these tumors, and 68 Ga DOTATOC is used in diagnostic imaging for the diagnosis and treatment of NETs [463, 464]

In conjunction with PET, diagnosis of somatostatin receptor-positive neuroendocrine tumors

2020

68 Ga-PSMA-11

RDC

68 Ga-PSMA-11 PET/CT can be used to evaluate the therapeutic effect and observe the reduction in tumor lesions, especially the invasion of surrounding tissues and organs (rectum, bladder), which has great value in determining subsequent surgical indications [465,466,467,468]

Imaging for diagnosis of prostate cancer

2020

64Cu DOTATATE

RDC

64Cu DOTATATE is a radio-diagnostic agent used for positron emission tomography and computed tomography (PET/CT). It can label somatostatin receptor with nuclide to locate neuroendocrine tumors [468,469,470,471]

Locating neuroendocrine tumors

2020

Melflufen

PDC

Because of its high lipophilicity, melflufen can rapidly penetrate cancer cells, hydrolyze aminopeptidase, and effectively induce the intracellular capture of L-PAM to rapidly release alkylating agent into cancer cells [472, 473]

Multiple myeloma, ovarian cancer, breast cancer, acute myeloid leukemia, hematologic imaging

2021

Illuccix

RDC

The FDA approved Illuccix as a radiometric diagnostic agent with a 68 Ga- radiolabel for PSMA-PET imaging in patients with prostate cancer suspected of metastasis

Treatment of castration-resistant prostate cancer

2021

LOCAMETZ

RDC

The FDA approved Locametz as a radiometric diagnostic agent for positron emission tomography (PET) of PSMA-positive lesions [474]

Treatment of castration-resistant prostate cancer

2022

Pluvicto

RDC

The FDA approved Pluvicto for the treatment of PSMA-positive advanced prostate cancer after progression with hormone therapy or chemotherapy

Treatment of castration-resistant prostate cancer

2022