RE:RE:Antibody-Drug-Conjugate (ADC) company reports patient death August 2022 - " The complexities of ADC activity in the clinic are only now becoming recognized"
Bystander death occurs when the cytotoxic payload harms cells that do not display the target antigen.
The ability of an ADC to produce cytotoxicity is determined by a number of factors, including the characteristics of the target antigen's properties, the choice of an antibody, the creation of a stable linker, and the conjugation of effective payloads.
Payload release in the bloodstream, non-malignant tissues, or the TME, as well as the payload's following effects in non-tumour tissues, could be implicated for off-target toxicities.
The complexity of ADC–tumor interactions can be better understood to determine the optimum ADC dosage strategies.
https://cancerci.biomedcentral.com/articles/10.1186/s12935-022-02679-8