Antibody–Drug Conjugates in the Treatment of Genitourinary Cancers - An Updated Review of Data

Sep 21, 2026

The treatment landscape of genitourinary cancers has significantly evolved over recent years, with renal cell carcinoma, bladder cancer, and prostate cancer representing the most common malignancies. The review focuses on antibody–drug conjugates (ADCs), describing their antigen-directed antibody design and cytotoxic payload release after binding. ADCs show strong promise across multiple cancer types, yet in GU cancers benefits are clearer for metastatic urothelial cancer. The study synthesizes preclinical work and clinical trials on utility, activity, toxicity, ADC development prospects, and ongoing trials, including prospective and retrospective evidence.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Keywords

Introduction

Targeted role of ADCs in GU cancers

Mechanisms of action and ADC components

Linker types and payload considerations

FDA and EMA approved ADCs

Review Antibody–Drug Conjugates in the Treatment of Genitourinary Cancers: An Updated Review of Data Prathana Nathan 1, Adnan Rajeh 2, Meh Noor 1, Gabriel Boldt 3 and Ricardo Fernandes 2,4, * Citation: Nathan, P.; Rajeh, A.; Noor, M.; Boldt, G.; Fernandes, R. Antibody–Drug Conjugates in the Treatment of Genitourinary Cancers: An Updated Review of Data. Curr. Oncol. 2024, 31, 2316–2327. [https://](https://)[ ](https://)[doi.org/10.3390/curroncol31040172](doi.org/10.3390/curroncol31040172) Received: 25 February 2024 Revised: 14 April 2024 Accepted: 14 April 2024 Published: 19 April 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Internal Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada 2 Division of Medical Oncology, Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada; [adnan.rajeh@lhsc.on.ca](adnan.rajeh@lhsc.on.ca) 3 London Regional Cancer Program, Victoria Hospital, London Health Sciences Centre, London, ON N6A 5W9, Canada; [gabriel.boldt@lhsc.on.ca](gabriel.boldt@lhsc.on.ca) 4 Cancer Research Laboratory Program, Lawson Health Research Institute, London, ON N6C 2R5, Canada * Correspondence: ricardo.fernandes@lhsc.on.ca Abstract: The treatment landscape of genitourinary cancers has signiﬁcantly evolved over the past few years. Renal cell carcinoma, bladder cancer, and prostate cancer are the most common genitourinary malignancies. Recent advancements have produced new targeted therapies, particularly antibody–drug conjugates (ADCs), due to a better understanding of the underlying oncogenic factors and molecular mechanisms involved. ADCs function as a `drug delivery into the tumor' system. They are composed of an antigen-directed antibody linked to a cytotoxic drug that releases cytotoxic components after binding to the tumor cell's surface antigen. ADCs have been proven tobe extremely promising in the treatment of several cancer types. For GU cancers, this novel treatment has only beneﬁted patients with metastatic urothelial cancer (mUC) . The rest of the GU cancer paradigm does not have any FDA-approved ADC treatment options available yet. In this study, we have thoroughly completed a narrative review of the current literature and summarized preclinical studies and clinical trials that evaluated the utility, activity, and toxicity of ADCs in GU cancers, the prospects of ADC development, and the ongoing clinical trials. Prospective clinical trials, retrospective studies, case reports, and scoping reviews were included. Keywords: genitourinary cancers; bladder carcinoma; urothelial carcinoma; kidney cancer; renal cell carcinoma; antibody–drug conjugates 1. Introduction Genitourinary (GU) malignancies are represented by a heterogenous group of cancers with various histology and biology, including renal cell carcinoma, bladder cancer, and prostate cancer. The treatment strategies for genitourinary malignancies have significantly evolved over the last two decades [1]. More recently, antibody–drug conjugates (ADCs) have gained attention in many different cancers. For instance, in the GU realm, a remarkable positive outcome has been shown with the combination of the antibody–drug conjugate (enfortumabvedotin) with pembrolizumab for the treatment of metastatic urothelial carcinoma [2]. ADCs have a unique characteristic and include a monoclonal antibody (mAb) bound to a cytotoxic molecule (payload), with a linker in between. These novel drugs are called“smart chemotherapy delivery” due to their ability to bind to the target (antigen on the surface of the cancer cell

FAQs

What are antibody–drug conjugates (ADCs) and how do they work?

ADCs combine an antigen-directed antibody with a cytotoxic drug linked by a linker. After binding to a surface antigen on cancer cells, the payload is released inside the cell, triggering cell death and immune-related effects like ADCC.

Which genitourinary cancers are highlighted in this updated review?

The review emphasizes renal cell carcinoma, bladder cancer, and prostate cancer as the most common genitourinary malignancies. It specifically discusses outcomes for metastatic urothelial cancer, where ADCs have benefited patients.

What evidence types are included in the narrative review?

The review includes prospective clinical trials, retrospective studies, case reports, and scoping reviews, alongside summarized preclinical studies and ongoing clinical trials assessing ADC utility, activity, and toxicity.

Sep 21, 2026

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