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CEACAM5-targeted antibody-drug conjugates (ADCs) represent a class of targeted antineoplastic biotherapeutics designed to deliver potent cytotoxic payloads directly to tumor cells expressing Carcinoembryonic Antigen-Related Cell Adhesion Molecule 5 (CEACAM5, also known as CEA or CD66e). CEACAM5 is a cell-surface glycoprotein that is highly overexpressed in a variety of epithelial malignancies, including colorectal, non-small cell lung, gastric, and pancreatic cancers, while maintaining low expression in normal adult tissues. These ADCs typically comprise a humanized anti-CEACAM5 monoclonal antibody conjugated via a chemical linker to a cytotoxic agent, such as the maytansinoid DM4, the topoisomerase I inhibitor SN-38, or monomethyl auristatin E (MMAE). Upon binding to the extracellular domain of CEACAM5, the ADC is internalized through endocytosis, followed by lysosomal degradation and intracellular release of the payload, which induces cell death through mechanisms like microtubule inhibition or DNA damage. Notable examples in this class include tusamitamab ravtansine (SAR408701), labetuzumab govitecan (IMMU-130), and PF-08046050 (SGN-CEACAM5C).
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