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An anti-5T4 antibody-drug conjugate (ADC) is a class of targeted cancer therapeutics designed to deliver cytotoxic payloads directly to cells expressing the oncofetal antigen 5T4 (trophoblast glycoprotein, TPBG). 5T4 is overexpressed on a wide variety of solid tumors, including non-small cell lung cancer (NSCLC), breast, gastric, and head and neck cancers, as well as on cancer stem cells (CSCs), while showing very limited expression in normal tissues. Several anti-5T4 ADCs have been developed, utilizing different antibodies, linkers, and payloads. For example, MEDI0641 (developed by MedImmune/AstraZeneca) is a site-specifically conjugated ADC consisting of an anti-5T4 human monoclonal antibody linked to a DNA-damaging pyrrolobenzodiazepine (PBD) dimer payload (SG3199) via a protease-cleavable valine-alanine linker. Other examples include PF-06263507 (Pfizer), which utilizes an auristatin payload, and SYD1875 (Byondis), which utilizes a duocarmycin payload. Upon binding to 5T4 on the cell surface, these ADCs are internalized, releasing their cytotoxic payloads to induce cell death in both bulk tumor cells and cancer stem cells.
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