Updated clinical evidence and molecular features of antibody-drug conjugates for advanced urothelial carcinoma

Platinum-based chemotherapy and immunotherapy are the primary systemic treatments for patients with advanced urothelial carcinoma (UC). However, the efficacy of these systemic therapies has yet to be optimized. Antibody-drug conjugates (ADCs), which combine the specificity of monoclonal antibodies with the cytotoxic potency of small-molecule drugs, have emerged as a promising new class of targeted therapies for UC. Currently, the Food and Drug Administration has approved 2 ADCs, namely Padcev and Trodelvy, for the treatment of advanced UC. This review provides an overview of the clinical evidence supporting the use of ADCs in patients with UC and summarizes the molecular features underlying these ADCs, which could be essential for understanding resistance mechanisms and minimizing treatment-related adverse events.