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Antibodies are found naturally in the blood stream to fight infections. Monoclonal antibodies (mABs) are similar to normal antibodies but are created in the laboratory. Monoclonal antibodies are directed against specific proteins that are exclusively, or excessively present on the cell surface of cancer cells. In an antibody-drug conjugate (ADC), a mAB is linked to a chemotherapeutic drug. The mAb circulates throughout the body until it can find and hook onto the target antigen after which the toxic substance is released where it is needed most. As such, ADCs combine the selectivity of a mAb with the cell-killing potential of chemotherapy.

Over the last decade, several ADCs have been introduced in the treatment landscape for different hematological malignancies, this includes brentuximab vedotin (Adcetris®) for the treatment of hodgkin lymphoma and certain non-hodgkin lymphomas, gemtuzumab ozogamicin (Mylotarg®) for the treatment of acute myeloid leukemia (AML) and inotuzumab vedotin (Besponsa®) for a subgroup of patients with acute lymphocytic leukemia (ALL).

Despite the more targeted delivery of the chemotherapeutic drugs, also ADCs come with side effects. Among others, this includes reduced blood counts, diarrhea, fatigue, nausea, and an increased risk for infections. In addition to this, the different ADCs also come with specific side effects. For example, brentuximab vedotin can cause a tingling feeling in the fingers or toes (sensory neuropathy), whereas belantamab mafodotin is associated with a specific set of eye-related side effects.

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