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Emiltatug ledadotin (XMT-1660; Emi-Le) is a B7-H4-directed Dolasynthen antibody-drug conjugate (ADC) developed by Mersana Therapeutics. It is designed with a precise drug-to-antibody ratio (DAR 6) and utilizes a proprietary auristatin F-HPA microtubule inhibitor payload that provides controlled bystander effect. The ADC targets the B7-H4 protein (V-set domain-containing T-cell activation inhibitor 1), which is overexpressed in several cancers including breast, endometrial, and ovarian cancer. Emiltatug ledadotin induces apoptosis and inhibits mitosis by disrupting tubulin polymerization in targeted tumor cells. It has shown promising early clinical activity and manageable safety in heavily pretreated patients with advanced or metastatic triple-negative breast cancer (TNBC), hormone-receptor positive/HER2-negative breast cancer, ovarian cancer, endometrial cancer, and adenoid cystic carcinoma type 1[1][5][6][8].
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