Antibody-drug conjugates: new drugs – new toxicities

PURPOSE OF REVIEW: Antibody-drug conjugates (ADCs) have reshaped the treatment of solid tumors, offering targeted delivery of cytotoxic agents using monoclonal antibodies to achieve precise antineoplastic effects. As the use of ADCs expands with the development of new agents and long-term safety data remain limited, clinicians must recognize, monitor, and manage treatment-related adverse events to optimize patient care. RECENT FINDINGS: With the expansion of available ADCs, a broad spectrum of acute and chronic toxicities emerged from off-target payload effects, monoclonal antibody components, and linker instability. Recent studies have shown ADCs are associated with both common and serious treatment-related toxicities, underscoring the need for tailored management strategies. SUMMARY: This comprehensive review discusses the toxicity profile of available ADC treatments for solid tumors and outlines practical approaches for toxicity monitoring and management. As the future of ADC therapy continues to evolve, integrating proactive toxicity mitigation and supportive care into clinical practice is crucial for maximizing therapeutic effect while also preserving patients' quality of life.