Targeted precision Strike in Extensive-Stage small cell lung Cancer: Current advances and future Perspectives for Antibody-Drug conjugates.

Small cell lung cancer (SCLC) is a highly aggressive neuroendocrine tumour with a poor prognosis. Although treatment regimens such as first-line immunochemotherapy have shown clinical benefits in extensive stage SCLC (ES-SCLC), patients still face disease recurrence and drug resistance. Antibody-drug conjugates (ADCs) are new therapeutic compounds made up of a monoclonal antibody (mAb) attached to a cytotoxic drug (payload) using a linker. They achieve precise killing of tumour cells by conjugating highly cytotoxic drugs with monoclonal antibodies targeting specific tumour antigens. In recent years, antigens such as B7-H3, Trop-2, SEZ6, DLL3, and EGFR-HER3 have become primary targets for ADC development in ES-SCLC. Although some ADCs have been limited due to toxicity-related issues, numerous other ADCs have entered clinical trial phases and demonstrated encouraging efficacy, with ORRs of 33.3 %-68.0 % and median PFS of 4.0-7.6 months. In this review, we systematically summarize ADCs currently in clinical trials and preclinical research for SCLC, and comprehensively discuss their pharmacodynamic characteristics, therapeutic effects, adverse effects, and strategies for optimising treatment.