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By coupling the antigen specificity of monoclonal antibodies with the cytotoxic strength of drug payloads, ADCs overcome limitations of conventional chemotherapy. This review surveys current ADC status in breast cancer, highlighting emerging targets, toxicity considerations, and key challenges, and proposes a three-dimension target framework to guide mechanism-based therapy.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/antibody-drug-conjugates-in-breast-cancer-from-mechanism-to-revolutionizing-clinical-practice/358148/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/antibody-drug-conjugates-in-breast-cancer-from-mechanism-to-revolutionizing-clinical-practice/358148.png","ImageObject",300,407,{"name":92,"@type":93},"pixelkiddo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"How do antibody-drug conjugates change the treatment paradigm in breast cancer?","Question",{"text":113,"@type":114},"ADCs shift management by combining monoclonal antibody targeting with potent cytotoxic payload delivery, enabling more effective and more targeted therapy than traditional chemotherapy.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What target framework does the review propose for ADCs in breast cancer?",{"text":118,"@type":114},"ADC targets are organized into three dimensions based on biological features: oncogenic driver antigens, lineage and oncofetal antigens, and tumor microenvironment antigens.",{"name":120,"@type":111,"acceptedAnswer":121},"Why is toxicity management and resistance still a major challenge for ADCs?",{"text":122,"@type":114},"Even with improved targeting, ADCs require careful toxicity management and face mechanism-based resistance, which can limit sustained clinical benefit.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},358148,1790165485,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},962090883892,"https://ap-avatar.wpscdn.com/avatar/e00115db34f3e0f11b?x-image-process=image/resize,m_fixed,w_180,h_180&k=1790152879550218658","Li etal. Molecular Cancer (2026) 25:215 Molecular Cancer  \n[https://doi.org/10.1186/s12943-026-02711-9](https://doi.org/10.1186/s12943-026-02711-9)  \nREVIEW Open Access  \nAntibody-drug conjugates in breast cancer: from mechanism to revolutionizing clinical practice  \nShuyu Li1, Zhouming Xu1,2, Wenhui Ruan1,3, Xiqing Wang1,4, Hongmei Yu1,5, Ming Yi1* and Peifen Fu 1*  \nAbstract  \nThe advent of antibody-drug conjugates (ADCs) has caused a paradigm shift in breast cancer management, transforming the treatment landscape from advanced lines to curative-intent settings. By integrating the specificity of monoclonal antibodies with the potency of cytotoxic payloads, ADCs have broken the limitations of traditional chemotherapy. This review aims to provide a comprehensive overview of the current state of ADCsin breast cancer, concentrating on targets under development, toxicity, and the challenges that remain to be overcome. Distinct from conventional classifications, we propose a framework categorizing ADC targets into three dimensions based on biological features: oncogenic driver antigens, lineage and oncofetal antigens, and tumor microenvironment antigens. Meanwhile, we discuss the structural evolution of ADCs, the management of toxicity, and the mechanism-based resistance. The future of treatment calls for precise ADC management, the use of next-generation bispecific ADCs and immune-oncology combinations, and the imperative of biomarker-guided sequencing.  \nKeywords Antibody-drug conjugates, Breast cancer, Molecular targets, Tumor microenvironment, Drug resistance, Toxicity management, Bystander effect, Combination therapy  \n*Correspondence: Ming Yi  \n[mingyi_onco@outlook.com](mingyi_onco@outlook.com); [mingyi2022@zju.edu.cn](mingyi2022@zju.edu.cn)  \nPeifen Fu  \n[fupeifen@zju.edu.cn](fupeifen@zju.edu.cn)  \n1Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou  \n310000, People’s Republic of China  \n2Department of Breast Surgery, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang 313300, China  \n3Department of Thyroid and Breast Surgery, People’s Hospital of Anji, Huzhou, Zhejiang 313300, China  \n4Department of General Surgery, The First People’s Hospital of Linan District, Hangzhou 311311, China  \n5Department of Thyroid and Breast Surgery, The First People’s Hospital of Tongxiang, Jiaxing 314500, China  \nIntroduction  \nAs the second most common cancer overall and the most frequently diagnosed malignancy in women, breast cancer (BC) stands as a significant global health challenge and the leading cause of cancer-related death among women. In 2022, there were approximately 20 million new cancer cases worldwide, among which 9.7 million were females, and breast cancer accounted for 2.31 million cases, causing 666,000 deaths globally in 2022 [1]. While substantial progress has been made in early detection and multimodal treatment, including surgery, radiotherapy, chemotherapy, endocrine therapy, and targeted agents, the management of advanced, metastatic, and treatment-resistant disease continues to cause difficulties in clinical management [2, 3].  \n© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by","cbCaiaEC3wsGfocd","https://ap.wps.com/l/cbCaiaEC3wsGfocd","pdf",4483759,29,"English","# Abstract\n# Introduction\n## Global burden and clinical challenges\n## Heterogeneity and limitations of current biomarkers\n## Emergence of targetable tumor antigens\n## Origins and core architecture of ADCs\n## Milestones in breast-cancer ADC development","[{\"question\":\"How do antibody-drug conjugates change the treatment paradigm in breast cancer?\",\"answer\":\"ADCs shift management by combining monoclonal antibody targeting with potent cytotoxic payload delivery, enabling more effective and more targeted therapy than traditional chemotherapy.\"},{\"question\":\"What target framework does the review propose for ADCs in breast cancer?\",\"answer\":\"ADC targets are organized into three dimensions based on biological features: oncogenic driver antigens, lineage and oncofetal antigens, and tumor microenvironment antigens.\"},{\"question\":\"Why is toxicity management and resistance still a major challenge for ADCs?\",\"answer\":\"Even with improved targeting, ADCs require careful toxicity management and face mechanism-based resistance, which can limit sustained clinical benefit.\"}]","Antibody-drug conjugates in breast cancer: from mechanism to revolutionizing clinical practice | PDF",1790133008,73]