Toxicities from Antibody-Drug Conjugates

Antibody-drug conjugates are becoming increasingly important in the treatment of many cancer types. The 3 main structural components - antibody, linker, and payload - each contribute to the toxicity profiles of these drugs. In addition to cytopenias and gastrointestinal adverse effects attributed to the chemotherapy payloads, each drug has specific toxicities that are not commonly described in oncology. Ocular, pulmonary, dermatologic, and neurologic toxicities are particularly nuanced. This review provides a framework for clinicians to analyze current and future antibody-drug conjugates and a description of the unique monitoring, preventive, and supportive care measures for these agents.