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ROR1 (Receptor Tyrosine Kinase Like Orphan Receptor 1) is an oncofetal antigen that is highly expressed during embryonic development but is largely absent in adult healthy tissues, while being overexpressed in various hematologic and solid tumors. ROR1 antibody-drug conjugates (ADCs) consist of a monoclonal antibody targeting ROR1, chemically linked to a potent cytotoxic payload. Upon binding to ROR1 on the surface of cancer cells, the ADC is internalized via endocytosis, leading to the intracellular release of the payload (often an anti-tubulin agent like monomethyl auristatin E or a DNA-damaging agent), which induces cell death. This targeted approach aims to maximize anti-tumor activity while minimizing off-target toxicity. Several ROR1 ADCs are currently in clinical development for indications such as chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), and various solid tumors including breast and lung cancer.
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