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Anti-B7-H3 antibody-drug conjugates (ADCs) are a class of targeted cancer therapeutics designed to deliver cytotoxic payloads specifically to cells expressing B7-H3 (CD276). B7-H3 is a member of the B7 family of immune checkpoint proteins and is frequently overexpressed in various solid tumors, including prostate, lung, breast, and ovarian cancers, while showing limited expression in normal tissues. These ADCs typically consist of a humanized monoclonal antibody targeting B7-H3, conjugated via a linker to a potent cytotoxic agent such as a DNA-alkylating agent (e.g., duocarmazine) or a topoisomerase I inhibitor (e.g., deruxtecan). Upon binding to B7-H3 on the tumor cell surface, the ADC is internalized, and the payload is released, leading to cell death. Several companies, including MacroGenics (vobramitamab duocarmazine), Daiichi Sankyo (ifinatamab deruxtecan), and Hansoh Pharma (HS-20093), are developing candidates in this class. MacroGenics' lead candidate, vobramitamab duocarmazine (formerly MGC018), utilizes a duocarmazine-based DNA-alkylating payload and has shown activity in metastatic castration-resistant prostate cancer and other solid tumors.
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