Mehmet Nuri BAŞER, Bilgin DEMİR
Acta Haematologica Oncologica Turcica - 2026;59(2):78-88
Breast cancer is the most common cancer in women worldwide and comprises numerous molecular subtypes. Antibody-drug conjugates (ADCs) are a new class of drugs that combine specific monoclonal antibodies with a cytotoxic drug and are also used in breast cancer treatment. This review discusses the ADCs ado-trastuzumab emtansine (T-DM1), trastuzumab deruxtecan (T-DXd), sacituzumab govitecan (SG), and datopotamab deruxtecan (Dato-DXd). These drugs have demonstrated significant benefits in overall survival in patients with human epidermal growth factor receptor 2 (HER2)-positive, HER2-low, hormone receptor-positive, and triple-negative breast cancer. T-DXd has extended the reach of HER2-targeted therapy to patients with HER2-low and HER2-ultralow disease; SG and Dato-DXd have emerged as effective options for patients with extensive prior treatment. In addition to therapeutic effectiveness, the individual adverse effect profiles of these medications must be carefully evaluated and managed. Important safety issues with these medications include thrombocytopenia and liver toxicity with T-DM1, interstitial lung disease/pneumonia with T-DXd, neutropenia and diarrhea with SG, and stomatitis and ocular damage with Dato-DXd. Ongoing clinical trials include investigations of early-stage therapies, new combination medicines, and next-generation research targeting resistance mechanisms associated with ADCs. As a result, ADCs have established a new standard in breast cancer treatment and play a vital role in personalized oncology.
