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Many immunotherapy papers introduce Antibody-Drug Conjugates (ADCs) as an emerging modality of immunotherapy, and the following is one example:

Marin-Acevedo, Julian A et al. “Cancer immunotherapy beyond immune checkpoint inhibitors.” Journal of hematology & oncology vol. 11,1 8. 12 Jan. 2018, DOI: 10.1186/s13045-017-0552-6

However, I find it difficult to understand why ADCs are regarded as 'immunotherapy'. If cancer-killing effect is achieved by the cytotoxin (payload) in ADC, isn't it just a targeted therapy (small-molecule therapy like Sunitinib or Sorafenib) with elaborate carriers?

Or, does the antibody part in ADC actually have therapeutic effects as well? Are they more than just carriers? If so, are there any papers which discuss this? I do not have a biology or immunology background so I may be missing a lot in terms of immunological mechanisms, I'd appreciate any insights or opinions.

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It's called immunotherapy because it uses an antibody which has been engineered to attack an immune target. These antibodies are collected from animals after immunizing them, or, synthesised using phages. It's a complex protein.

In the other hand the other drugs you mentioned are small molecules that can be synthesized without the use of phages or animals. Usually any drug company can make these whereas antibody based drugs need biological soups costing millions of dollars to manufacture hence their expense.

https://www.proteogenix.science/scientific-corner/antibody-production/antibody-synthesis-development-new-drugs/

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