Specificity: The Key to Smarter ADCs for GI Cancers

In an interview with Targeted Oncology, Sarbajit Mukherjee, MD, gastrointestinal (GI) medical oncologist at Baptist Health Miami Cancer Institute, considers the future of antibody–drug conjugates (ADCs) in GI cancers—the subject of his recent talk at the Baptist Health Miami Cancer Institute’s fourth annual Precision Oncology Symposium in January.

Watch part 1 and part 2 of Dr Mukherjee’s interview.

Dr Mukherjee highlights that the true potential lies in the evolution of the ADC platform as a whole rather than a single breakthrough drug—improvements in payload design, linkers, and clinical trial design are all essential for refining how these treatments are administered to patients.

A core component of this progress is the rigorous application of precision medicine. Dr Mukherjee emphasizes that ADCs cannot be used as a universal treatment for all patients; rather, the agents’ therapeutic impact depends on selective use within specific disease settings. This requires a sophisticated understanding of disease biology to identify which patients will benefit most.

While the overall platform design and biology are critical, the identification of specific molecular targets remains a vital area of research. Dr Mukherjee is particularly enthusiastic about CLDN18.2, a target that has shown significant promise because it is expressed across various GI malignancies, including pancreatic and gastroesophageal cancers. Several next-generation ADCs targeting CLDN18.2 are currently under development, representing a major step forward in the field.

Ultimately, the next generation of GI cancer treatment will be defined by smarter trial designs and a transition toward targeted specificity. By combining advanced engineering with a selective approach to patient biology, clinicians are currently striving to optimize the use of ADCs to achieve the greatest possible success in treating complex GI tumors.

Read the full interview here.