Objective:

To explore how antibody-drug conjugates (ADCs) can achieve meaningful efficacy while ensuring tolerability for patients, emphasizing the balance between the two.

Key Findings:

• Tolerability is now the primary bottleneck in ADC development, overshadowing potency, as patients prioritize their daily quality of life.
• Patients prioritize daily quality of life over understanding the biological mechanisms of their treatments, highlighting the need for patient-centered design.
• Current ADCs often rely on a limited class of toxic payloads, necessitating a shift towards more selective and less toxic options to improve tolerability.

Interpretation:

The future of ADCs lies in designing therapies that are not only effective but also kinder to patients, focusing on tolerability and quality of life as central themes.

Limitations:

• The discussion reflects the perspectives of a specific panel and may not encompass all views in the ADC development community, potentially introducing bias.
• The feasibility of implementing new payloads and linker designs remains to be validated in clinical settings, which could impact their practical application.

Conclusion:

A paradigm shift in ADC development is essential, focusing on patient-centric approaches that enhance tolerability and quality of life, ultimately leading to better therapeutic outcomes.