Presentation (CTI)

OBJECTIVES: Antibody-drug conjugates (ADCs) are an innovative class of therapies that link cytotoxic drugs (payloads) to monoclonal antibodies (mAbs) through covalent bonds. This approach targets tumor tissues expressing specific antigens, potentially enhancing the therapeutic ratio. Multiple ADCs have received approval from the Food and Drug Administration (FDA) and are currently available on the market, providing therapeutic benefits for various cancers. Our study aims to investigate FDA-approved ADCs that have been submitted to NICE for approval.
METHODS: We searched NICE HTA database for all ADCs for which NICE submissions have been submitted. All of these ADCs were assessed by NICE from inception to 2024
RESULTS: 12 FDA-approved ADCs were identified: Trastuzumab emtansine, Trastuzumab deruxtecan, Sacituzumab govitecan, Inotuzumab ozogamicin, Polatuzumab vedotin, Loncastuximab tesirine, Tisotumab vedotin, Enfortumab vedotin, Mirvetuximab soravtansine-gynx, Belantamab mafodotin-blmf, Gemtuzumab ozogamicin, and Brentuximab vedotin. These ADCs were indicated for the treatment of various cancers, including breast cancer, diffuse large B-cell lymphoma, acute lymphoblastic leukemia, cervical cancer, urothelial carcinoma, ovarian cancer, multiple myeloma, anaplastic large cell lymphoma, and acute myelogenous leukemia. Among these twelve ADCs, four—Tisotumab vedotin, Enfortumab vedotin, Mirvetuximab soravtansine, and Belantamab mafodotin—were under review by NICE. Three of the ADCs were recommended for first-line treatment, while the others were recommended for second and third-line treatments. Data for all submissions were sourced from randomized controlled trials, except for one where non-randomized controlled trial was used. Most of the submissions included cost-effectiveness analyses, with willingness-to-pay thresholds ranging from 10,000 to 30,000 Euros per QALY gained.
CONCLUSIONS: In conclusion, ADCs have revolutionized cancer treatment with their targeted delivery and significant therapeutic benefits. The evolution of ADCs since 2000 highlights their potential in both refractory and early-stage diseases. Continued advancements in ADC design and technology promise even greater therapeutic efficacy. The future of ADCs looks bright, with innovations poised to further enhance their clinical impact.