
{"id":16928,"date":"2025-04-25T14:44:45","date_gmt":"2025-04-25T14:44:45","guid":{"rendered":"https:\/\/www.sygnaturediscovery.com\/blog\/toxicity-efficacy-in-adcs\/"},"modified":"2025-04-25T14:44:45","modified_gmt":"2025-04-25T14:44:45","slug":"toxicity-efficacy-in-adcs","status":"publish","type":"blog","link":"https:\/\/www.sygnaturediscovery.com\/fr\/blog\/toxicity-efficacy-in-adcs\/","title":{"rendered":"Toxicity &#038; Efficacy in ADCs: How to Get it Right"},"content":{"rendered":"<p><span style=\"font-size: 18pt;\">Antibody-Drug Conjugates (ADCs) still face significant challenges related to patient tolerability and therapeutic window, and ADCs often fail to significantly reduce toxicity compared to traditional cytotoxic agents, highlighting the ongoing struggle to improve specificity and safety.\u00a0<\/span><\/p>\n<p>\u00a0<\/p>\n<h2><span style=\"font-size: 24pt;\"><b>Selective Targeting and Payload Design (\u2018Selectivity Squared\u2019)<\/b>\u00a0<\/span><\/h2>\n<p><span style=\"font-size: 18pt;\">Traditional ADC payloads typically fall into three main classes, each designed to disrupt cancer cell survival through distinct mechanisms. Microtubule inhibitors, such as MMAE and DM1, interfere with spindle formation in mitosis. Auristatins such as MMAE bind to the side of forming spindles causing kinks which results in improper alignment, whilst maytansinoids bind to the spindle terminus directly inhibiting its growth. Topoisomerase I inhibitors, including DXd and SN-38, inhibit the topo 1 enzyme which helps to regulate DNA under- and over-winding to remove knots and tangles from the genetic material, topo1 functions by creating single-stranded breaks in DNA which is key to cell regulation. Meanwhile, DNA-damaging\/chelating agents\u2014often highly potent\u2014directly compromise DNA by binding into the minor groove and covalently bonding.\u00a0<\/span><\/p>\n<p><span style=\"font-size: 18pt;\">A common trait with all the mechanisms employed by conventional ADC cytotoxic payload is that each is present in both healthy and disease state cells, thus limiting selectivity and substantially increasing the prevalence of systemic payload mediated toxicity. \u00a0<\/span><\/p>\n<p><span style=\"font-size: 18pt;\">Increasing the therapeutic window may involve enhancing both the selectivity of the antibody and the specificity of the payload. Modifying linker chemistry and optimizing payload conjugation are crucial, as even minor changes can drastically affect the balance between efficacy and toxicity. This is where the concept of a biologic\/ chemical bispecific molecule\u00a0comes into play. The combination of a highly specific antibody with a targeted small molecule therapeutic can\u00a0maximize targeted action, an approach we informally refer to as \u201cselectivity squared\u201d. Rather than relying solely on the antibody for specificity, we\u2019re now integrating selectivity at multiple levels\u2014the antibody, the small molecule payload, and even the linker.\u00a0<\/span><\/p>\n<p>\u00a0<\/p>\n<h2><span style=\"font-size: 24pt;\"><b>Multidisciplinary Approach to ADC Development<\/b>\u00a0<\/span><\/h2>\n<p><span style=\"font-size: 18pt;\">Achieving this selectivity requires a <a href=\"https:\/\/www.sygnaturediscovery.com\/drug-discovery\/integrated-drug-discovery\/antibody-drug-conjugates\/\" target=\"_blank\" rel=\"noopener\">multidisciplinary approach<\/a>, bringing together chemistry, bioscience, DMPK, and both <em>in vivo<\/em> efficacy and <em>ex vivo<\/em> PK to understand how subtle changes can have a significant impact the overall therapeutic profile. We\u2019re used to developing small molecules and we\u2019re used to small changes having significant effects on PK and toxicity and overall therapeutic profile.\u00a0<\/span><\/p>\n<p><span style=\"font-size: 18pt;\">It\u2019s no different in this emerging ADC paradigm. Every single atom change, linker adjustment, or payload modification can dramatically shift an ADC from a highly selective therapeutic to an ineffective or less selective compound. By embracing a holistic perspective\u2014one that sees ADCs as hybrid molecules rather than just targeted delivery vehicles\u2014we can unlock new potential and rethink how selectivity is built from the ground up.\u00a0<\/span><\/p>\n<p><span style=\"font-size: 18pt;\" data-ccp-props='{\"335559738\":240,\"335559739\":240}'>\u00a0<\/span><\/p>\n<h3><span style=\"font-size: 18pt;\"><strong>Catch up on the previous parts in our ADC development blog series:<\/strong><\/span><\/h3>\n<p><span style=\"font-size: 18pt;\">Part 1: <a href=\"https:\/\/www.sygnaturediscovery.com\/news-and-events\/blog\/exploring-new-paths-in-adc-development\/\" target=\"_blank\" rel=\"noopener\">Exploring new paths in ADC development<\/a><\/span><\/p>\n<p><span style=\"font-size: 18pt;\">Part 2: <a href=\"https:\/\/www.sygnaturediscovery.com\/news-and-events\/blog\/evolving-role-of-med-chem-in-adc-development\/\" target=\"_blank\" rel=\"noopener\">What\u2019s the Evolving Role of Medicinal Chemistry in ADC Development?<\/a><\/span><\/p>\n<p><span style=\"font-size: 18pt;\">Part 3: <a href=\"https:\/\/www.sygnaturediscovery.com\/news-and-events\/blog\/linker-technologies-in-adcs\/\" target=\"_blank\" rel=\"noopener\">Linker Technologies in ADCs: How They Impact Efficacy &amp; Stability<\/a><\/span><\/p>\n<p>\u00a0<\/p>\n<h3><strong><span style=\"font-size: 18pt;\">About the Authors<\/span><\/strong><\/h3>\n<p><span style=\"font-size: 18pt;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-18115 size-medium\" src=\"https:\/\/www.sygnaturediscovery.com\/wp-content\/uploads\/2025\/04\/SDpodcast_web-11-e1744109146956-800x593.jpg\" alt=\"Picture of Allan Jordan, VP of Oncology Drug Discovery at Sygnature Discovery and Joshua Greally, ADC Lead and Business Development Associate for Drug Discovery Services at Sygnature Discovery, filming the podcast style video series: ADc Development for Sygnature's NewPath ADC series\" width=\"300\" height=\"222\">Allan Jordan is Vice President Oncology Drug Discovery at Sygnature Discovery and Josh Greally is ADC Lead at Sygnature Discovery. Follow their <a href=\"https:\/\/youtu.be\/4Q0WgzbY4Kc\" target=\"_blank\" rel=\"noopener\">ADC development series<\/a> on YouTube to hear all their insights.<\/span><\/p>\n<p>\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":8075,"template":"","category":[1409,820],"class_list":["post-16928","blog","type-blog","status-publish","has-post-thumbnail","hentry","category-adcs","category-modalites"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Toxicity &amp; Efficacy in ADCs: How to Get it Right - Sygnature<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.sygnaturediscovery.com\/fr\/blog\/toxicity-efficacy-in-adcs\/\" \/>\n<meta property=\"og:locale\" content=\"fr_CA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Toxicity &amp; 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