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Systemic therapy
Antibody-drug conjugates
A targeting antibody carrying a chemotherapy payload directly to the cell.
What it is
An ADC is two things joined: an antibody that recognises a marker on the tumour cell, and a potent drug attached to it. The antibody delivers; the payload does the damage.
Because the payload is far more toxic than ordinary chemotherapy, the targeting has to be right. That means the marker must be confirmed on your tissue before the medicine is considered.
When it is used
- Where the target marker is confirmed on testing, at a defined expression level
- In specific disease settings where an ADC is an established option
- Often after other systemic treatment, though increasingly earlier in defined situations
How the decision is made
- Marker confirmation and expression level, on adequate tissue. An ambiguous report is reviewed independently before a decision this expensive is made.
- Anticipated toxicities, which differ by payload, lung, eye, nerve and blood effects vary between agents.
- Total course cost and access programme mapping, before cycle one.
Infusion at a partner day-care unit. The medicine is billed by whoever supplies it.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Marker testing strategy, ordered and signed by an oncologist
- Independent pathology review of the marker result
- Board candidacy assessment
- A written toxicity surveillance schedule specific to the agent
- Access and assistance mapping
Performed and billed elsewhere
- The infusion
- The medicine
- Imaging for response assessment
- New breathlessness or a dry cough on an ADC is reported the same day, not at the next cycle. Some payloads affect the lungs and early recognition matters.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- What marker was tested, and at what level?
- What are the specific side effects of this payload?
- What is the whole-course cost, and is there an assistance programme?
- What is the plan if it stops working?
Support that goes with it
Research behind this
Where this is used
Cancers this commonly forms part of
Breast cancer
Including hormone-receptor positive, HER2-positive and triple-negative disease
Stomach cancer
Gastric cancer
Lung & thoracic cancer
Non-small cell and small cell lung cancer, mesothelioma, thymic tumours
Bladder cancer
Urothelial carcinoma of the bladder
Ovarian cancer
Epithelial ovarian, fallopian tube and primary peritoneal cancer
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.