Three-minute explainer: Getting to know your ADCs


ADC? ABC, surely?

Nope. The latest advance in cancer treatment, actually. Antibody-drug conjugates; heard of them?

Not a Scooby

Well, let me give you the ‘sciency’ exposition. Then I’ll provide the layperson’s commentary. Here we go:

“Antibody-drug conjugates or ADCs are highly targeted biopharmaceutical drugs that combine monoclonal antibodies specific to surface antigens present on particular tumour cells with highly potent anti-cancer agents linked via a chemical linker.”

Erm, thanks

Okay, the above comes from the ADC Review and it’s the LEAST jargon-filled definition we could find.

Here’s how I might explain ADCs over a quiet G&T

Key to the technology is a chemical linker used to attach a cancer cell killing small molecule drug called a cytotoxin to the larger antibody that has been selected to target the particular form of cancer being treated.

So, if the traditional monoclonal antibody drugs used to treat cancer are the bouncing bombs used by the Dam Busters in the Second World War (effective up to a point), ADCs are state-of-the-art missiles that find the exact target with the correct explosive payload.

Tell me more

There are 10 ADCs currently commercially available making up a market worth US$3bn today. That figure looks set to rise to US$15bn on a risk-adjusted basis by 2025, according to the German investment bank Berenberg, and US$28bn by 2030.

Wow. Anyone we know involved?

The big winners in the market are likely to Lonza Group (SWX:LONN), which currently manufactures around half the approved ADC-based products, and AstraZeneca (LON:AZN).

What do the City’s financial wonks think?

“Key features of ADCs include the ability to use highly potent payload and bystander effect, the ability to kill neighbouring cancer cells regardless of target expression,” Berenberg said in a recent note to clients.

“We believe these features provide a unique advantage for late-stage, heterogeneous solid tumours that are difficult to treat using other drug modalities.”

Enhertu and Trodelvy – two of the new, targeted drugs – have shown “impressive efficacy” in third-line breast cancer, the German bank pointed out.

The latter is a Gilead product while the former is from the AZ stable. Berenberg expects upcoming trial results in the coming months to open a US$2bn market for Enhertu.


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