Antibody-drug conjugates in haemato-oncology

Antibody-drug conjugates (ADCs) are a targeted therapeutic class primarily used in haematology and oncology. They are designed to selectively bind antigens that are overexpressed on tumour cells while sparing normal tissues. ADCs consist of three key components: a monoclonal antibody, a cytotoxic payload, and a linker that connects the two. In haemato-oncology, particularly in the treatment of resistant and solid tumours, there remains an urgent need for more effective targeted therapeutic options. The therapeutic concept of ADCs is to combine the specificity of the antibody with the cytotoxic potency of the payload, thereby selectively damaging tumour cells. The data presented in this master’s thesis were obtained through a systematic literature review, primarily using PubMed, Web of Science, BASE and Google Scholar. Currently, 16 ADCs are approved worldwide. Despite this progress, there remains substantial potential for further development, while resistance mechanisms continue to limit their clinical efficacy. This thesis provides an overview of the current landscape of ADCs and their structural characteristics, followed by a detailed presentation of known resistance mechanisms. Emerging technologies and future developments in ADC design are presented, with a focus on how these innovations may overcome current limitations in efficacy.