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3 February 2024

Recent Technological and Intellectual Property Trends in Antibody–Drug Conjugate Research

,
and
1
Department of Safety Engineering, Chungbuk National University, Cheongju 28644, Chungbuk, Republic of Korea
2
Department of BigData, Chungbuk National University, Cheongju 28644, Chungbuk, Republic of Korea
3
Department of Biotechnology, CHA University, Pocheon 11160, Gyeonggi, Republic of Korea
*
Author to whom correspondence should be addressed.
This article belongs to the Special Issue Nano Drug Delivery System, 2nd Edition

Abstract

Antibody–drug conjugate (ADC) therapy, an advanced therapeutic technology comprising antibodies, chemical linkers, and cytotoxic payloads, addresses the limitations of traditional chemotherapy. This study explores key elements of ADC therapy, focusing on antibody development, linker design, and cytotoxic payload delivery. The global rise in cancer incidence has driven increased investment in anticancer agents, resulting in significant growth in the ADC therapy market. Over the past two decades, notable progress has been made, with approvals for 14 ADC treatments targeting various cancers by 2022. Diverse ADC therapies for hematologic malignancies and solid tumors have emerged, with numerous candidates currently undergoing clinical trials. Recent years have seen a noteworthy increase in ADC therapy clinical trials, marked by the initiation of numerous new therapies in 2022. Research and development, coupled with patent applications, have intensified, notably from major companies like Pfizer Inc. (New York, NY, USA), AbbVie Pharmaceuticals Inc. (USA), Regeneron Pharmaceuticals Inc. (Tarrytown, NY, USA), and Seagen Inc. (Bothell, WA, USA). While ADC therapy holds great promise in anticancer treatment, challenges persist, including premature payload release and immune-related side effects. Ongoing research and innovation are crucial for advancing ADC therapy. Future developments may include novel conjugation methods, stable linker designs, efficient payload delivery technologies, and integration with nanotechnology, driving the evolution of ADC therapy in anticancer treatment.

1. Background of ADC Therapeutic Technology

The antibody–drug conjugate (ADC) therapy technology is a next-generation therapeutic approach to overcome the limitations of conventional cancer chemotherapy. It is considered one of the next-generation anticancer treatment technologies that leverage the targeted selectivity of antibodies and the cell-killing efficacy of cytotoxic drugs to enhance therapeutic effects while minimizing side effects [1,2,3,4]. This technology involves the use of a drug composed of a low-molecular-weight cytotoxic agent (chemotherapeutic drug) chemically linked to an antibody that interacts with a specific antigen overexpressed on the surface of cancer cells through a chemical linker (Figure 1). This structure allows for the targeted delivery of the cytotoxic drug to cancer cells, enhancing the effectiveness of the anticancer treatment while minimizing adverse effects.
Figure 1. Characteristics and structure of ADC [1]. Copyright 2022 Springer Nature.
The optimal ADC therapy is characterized by its ability to maintain stability in the bloodstream, accurately reach targeted cancer cells, and ultimately release the cytotoxic payload in close proximity to the specified cancer cells for effective treatment. Essential components of ADCs in achieving these objectives encompass tumor-targeting antibodies designed to correspond to antigens expressed on cancer cells, along with linkers and cytotoxic payloads. The conjugation methods employed for these components represent a critical technological aspect in ADC manufacturing, enabling the precise assembly of these elements and ensuring optimal therapeutic outcomes.

1.1. Selection of Target Antigens

The target antigen expressed on cancer cells serves as the navigation system for ADC therapy, determining the mechanism for recognizing cancer cells and delivering the cytotoxic payload. The selection of an ideal target antigen is the first crucial consideration in this process. The criteria for the ideal selection of a target antigen typically involve its overexpression in cancer cells while being rare or very lowly expressed in normal tissues. Additionally, the antigen should be expressed on the surface of cancer cells. It is also essential that the chosen antigen is not secreted in the bloodstream to avoid unwanted binding of ADCs in undesired locations. Currently developed ADC therapies have selected target antigens such as HER2, trop2, nectin4, and EGFR for solid tumors and CD19, CD22, CD33, CD30, BCMA, and CD79b for hematologic malignancies [1,5,6]. These antigens have been chosen based on their overexpression in cancer cells and their suitability for effective ADC therapy.

1.2. Cancer Cell-Targeting Antibodies

Antibodies targeting cancer cells play a pivotal role in facilitating specific binding between the target antigen and ADCs. These antibodies should demonstrate high binding affinity to the target antigen, low immunogenicity, and an extended half-life. In the initial stages of ADC therapy development, antibodies derived from mice were commonly utilized. However, due to severe immunogenic side effects, especially associated with murine antibodies, the prevailing trend now predominantly favors the use of humanized antibodies produced through recombinant technology [7,8,9]. Humanized antibodies are generated by incorporating key regions of the mouse-derived antibody into a human antibody framework. This approach preserves the specificity and high binding affinity of the mouse antibody while minimizing the risk of immune reactions in humans. The transition towards humanized antibodies has significantly contributed to enhancing the safety and efficacy of ADC therapies.

1.3. Linkers

The linker in ADCs plays a crucial role in bridging the antibody and the cytotoxic drug, representing a critical determinant of ADC stability and the profile of payload drug release. This, in turn, significantly influences therapeutic efficacy. An ideal linker should avoid inducing ADC aggregation, prevent premature payload release in the bloodstream, and facilitate the release of active drugs precisely at the desired target. Linkers are broadly classified into two main types based on cellular metabolism processes [10,11,12,13]: cleavable linkers and non-cleavable linkers. Cleavable linkers are further subdivided into chemical cleavage linkers and enzyme cleavage linkers. These linkers offer the advantage of precisely releasing cytotoxic drugs, taking into account systemic circulation and environmental disparities between normal cells and cancer cells. On the contrary, non-cleavable linkers are connected as amino acid residues within the breakdown products of the antibody, displaying low activity in the general chemical and enzymatic environments within the body, ensuring high plasma stability. Typically, non-cleavable linkers rely on enzyme hydrolysis of the ADC’s antibody component, primarily facilitated by proteases, culminating in the release of the payload in a complex form.

1.4. Cytotoxic Payloads

The cytotoxic payload is the component of ADCs that signifies the drug’s cytotoxic effect upon penetration into cancer cells. Given that only approximately 2% of ADCs can reach the targeted tumor site after intravenous administration, it is imperative to employ a highly effective compound as the payload. This compound should demonstrate stability under physiological conditions and possess functional groups capable of binding to antibodies. Currently, cytotoxic payloads used in ADCs primarily include potent tubulin inhibitors, DNA-damaging agents, and immunomodulators [14,15]. These compounds are selected for their capacity to exert a robust therapeutic effect within cancer cells. Tubulin inhibitors disrupt microtubule dynamics, affecting cell division; DNA-damaging agents induce DNA damage to inhibit cell proliferation, and immunomodulators modulate the immune response within cancer cells. The meticulous choice of the cytotoxic payload is crucial for attaining the desired therapeutic outcomes in ADCs [16,17,18,19] (Table 1).
Table 1. Representative small molecular cytotoxic payloads [19].

1.5. Conjugation Methods

In addition to the selection of antibodies, linkers, and payloads, the method by which the small-molecule component (e.g., linker plus payloads) is attached to the antibody is a crucial element in the successful construction of ADCs [20,21,22]. Antibodies typically contain residues for binding reactions, such as lysine and cysteine residues. In the early development of ADC drugs, conventional coupling methods often used existing lysine or cysteine residues on the antibody through appropriate coupling reactions [23,24]. One of the most commonly used methods for connecting the payload to the lysine residues of the antibody is through the amide coupling reaction, using an active carboxylic acid ester [25,26,27]. However, the abundant presence of lysine complicates the control of site selectivity, resulting in challenges such as premature payload release and the potential for off-target toxicity.
To address these limitations, innovative strategies for ADCs, including site-specific conjugation methods, are currently in development [28,29,30,31]. Site-specific conjugation methods present a groundbreaking approach in ADC development, aiming to precisely attach the payload at specific locations and overcome challenges associated with traditional coupling methods. For example, the introduction of engineered reactive cysteine residues selectively inserted at specific positions enables precise conjugation at that site, enhancing the homogeneity of ADCs and providing tunable reactivity through the alteration of the modification site [32,33,34]. In enzymatic conjugation methods, a variety of enzymes, such as bacterial-derived formyl glycine-generating enzymes, transglutaminases, glycotransferases, and sortases, have been utilized for tag-free antibody modification techniques [35,36,37,38,39]. The reaction sites of antibodies are designed to specifically interact with the corresponding functional groups, facilitating site-specific conjugation in enzymatic methods. The incorporation of unnatural amino acids with bioorthogonal groups is also employed in site-specific conjugation [40,41,42,43]. The most common method of incorporation involves engineering transfer RNA synthetases to recognize the unnatural amino acids, resulting in the genetic coding of these unconventional building blocks. Enzymatic conjugation methods provide precise control over the site of conjugation, reducing heterogeneity and enhancing the therapeutic index of ADCs. Tag-free techniques, particularly those based on enzymatic modification, often yield conjugates with reduced immunogenicity.

4. Conclusions and Future Perspectives

Antibody–drug conjugate (ADC) therapy emerges as a transformative technology, surmounting the constraints of traditional chemotherapy by leveraging targeted antibodies. Through extensive research and development, the fusion of diverse antibodies and cytotoxic payloads provides avenues for treating various cancer types. Presently, numerous pharmaceutical entities are leveraging ADC therapy to advance novel drugs, progressing through clinical trials. Over the last two decades, ADC therapy has witnessed remarkable strides, securing approvals for diverse cancer targets. The development of numerous ADC therapies, addressing hematologic and solid tumors, is reflected in the multitude of candidates currently undergoing clinical trials, pivotal for assessing efficacy and safety. The past five years have marked a substantial upswing in research and development concentration and patent filings concerning ADC therapy. Leading this technological frontier are notable patent applicants, including Pfizer Inc. (USA), AbbVie Pharmaceuticals Inc. (USA), Regeneron Pharma Inc. (USA), and Seagen Inc. (USA), steering advancements in the field.
ADC technology, while brimming with promise for cancer treatment, faces significant challenges that impact its clinical success. These challenges encompass antigen expression discrepancies, tumor heterogeneity, off-target toxicities, immunogenicity, and pharmacokinetic hurdles. Effectively addressing these issues necessitates a multidisciplinary approach involving molecular biology, pharmacology, and clinical medicine. Ongoing research and innovations in ADC technology strive to overcome these obstacles by reinforcing antibody stability, optimizing payload selection, refining linker conjugation methods, and exploring synergies with nanotechnologies. Collaborative efforts across scientific disciplines are indispensable, playing a pivotal role in unlocking the full potential of ADCs in cancer treatment. This sustained collaboration aims to deepen our understanding of challenges and opportunities, ultimately driving advancements that elevate the efficacy and safety of ADCs in the battle against cancer.

Author Contributions

Conceptualization, S.H.; literature study, Y.C. (Youngbo Choi) and Y.C. (Youbeen Choi); methodology and analysis, Y.C. (Youngbo Choi); investigation, S.H. and Y.C. (Youngbo Choi); data curation, S.H. and Y.C. (Youngbo Choi); writing—original draft preparation, S.H.; writing—review and editing, Y.C. (Youngbo Choi); visualization, Y.C. (Youbeen Choi); supervision, S.H.; project administration, S.H.; funding acquisition, S.H. and Y.C. (Youngbo Choi). All authors have read and agreed to the published version of the manuscript.

Funding

The research described in this work received support from the National Research Foundation of Korea (2022R1F1A10738471212782127670102, 2022R1F1A1074443) and the Korea Technology and Information Promotion Agency for SMEs (TIPA), funded by the Ministry of SMEs and Startups (G21S330218702).

Institutional Review Board Statement

Not applicable.

Data Availability Statement

Not applicable.

Conflicts of Interest

The manuscript submitted here has not been published or presented elsewhere, either in part or in its entirety, and is not currently under consideration by any other journal. We have thoroughly reviewed and understood the policies of your journal, and we affirm that this manuscript and the study described within it comply with these policies. Additionally, we declare that there are no conflicts of interest associated with this submission.

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