What Do Physicians and Patients Think About ADCs as Cancer Treatment?

Aditya Bardia, MD, MPH, FASCO, believes that antibody-drug conjugates (ADCs) are superior to chemotherapy when it comes to efficacy, though they leave patients experiencing higher levels of toxicity.

Bardia, a professor in the department of medicine in the Division of Hematology/Oncology, the director of Translational Research Integration, and a member of Signal Transduction and Therapeutics at the University of California Los Angeles Health Jonsson Comprehensive Cancer Center, spoke with CancerNetwork® at the 16th Annual World ADC Summit in San Diego, CA, following his presentation titled, “Reviewing the ADC Clinical & Approval Landscape: What Direction are ADCs Heading to Reshape Frontline Oncology Treatments For Patients”.

When comparing ADCs with chemotherapy, Bardia noted that the biggest obstacles stem from the high levels of toxicity, which include hair loss and alopecia, which in turn require higher levels of multidisciplinary care. G-CSF and anti-nausea medication were one example of toxicity-mitigating measures that he highlighted as requiring multidisciplinary collaboration.

Additionally, as often noted by physicians, he also added that patients, both in surveys and in their general feedback, state that the toxicity profiles of ADCs need to be improved.

Transcript:

If we compare ADCs with chemotherapy, I would like to make 3 points. First, in general, we are seeing that ADCs, from an efficacy perspective, are superior to chemotherapy. What we’ve seen in clinical trials, in general, [is what we are seeing] in clinical practice. The second is that, from a toxicity perspective, many of the ADCs do have [adverse] effects that are similar to chemotherapy, be it nausea, hair loss, decreases in white blood cells, and myelosuppression. Which brings me to the third point: we do need multidisciplinary management with chemotherapy. We’ve become very good in terms of supportive therapy, use of G-CSF, and anti-nausea medication. For ADCs, we need to ensure that we have good supportive therapy management, so patients not only have prolonged survival, but are able to maintain their quality of life.

From a patient perspective, and there have been surveys, the feedback that I’ve received is that the efficacy is great, but we really need to improve on the toxicity profile of ADCs as well. For the field, that is the challenge. Hopefully, in the next few years, we can develop ADCs that have [less] toxicity. [This is] nothing against the ADCs we have right now—they are phenomenal, and they’ve changed how we practice oncology—but in terms of iterative improvement, an improvement in the toxicity profile would be welcome.

Reference

Bardia A. Moving forward with ADCs in clinic: challenges and opportunities. Presented at the 2025 World Antibody Drug Conjugate Conference; San Diego, CA; November 3-6, 2025.