Antibody-drug conjugates in gynecologic malignancies

Antibody drug conjugates (ADCs) are an exciting class of oncologic therapeutics. ADCs have been FDA approved in hematologic malignancies and breast cancer and are a growing area of study in numerous solid malignancies. The desire for tumor-specific therapies with decreased systemic toxicity has driven over a decade of research into the design and optimization of ADCs, which are now in a third generation of development. Gynecologic malignancies in particular suffer a dearth of novel therapies. This review will examine the field of ADCs in gynecologic cancers, focusing on ADCs targeting folate receptor alpha (FRα), mesothelin, tissue factor, MUC16 (CA125), NaPi2B, and Trop2. •ADCs are a rapidly growing class of oncologic agents that can confer tumor-specific delivery of a cytotoxic agent.•Mirvetuximab soravtansine is an anti-folate receptor alpha ADC currently in phase III clinical trials in ovarian cancer.•Mesothelin, tissue factor, MUC16 (CA125), NaPi2B, and Trop2 are additional ADC targets studied in gynecologic malignancies.