SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Comparative efficacy of antibody-drug conjugates and chemotherapy for malignant tumors: A systematic review and meta-analysis
Provisionally accepted
- Zhejiang Chinese Medical University, Hangzhou, China
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Background Despite advancements in cancer treatment, malignant tumors remain a significant global health challenge. Drawbacks of chemotherapy, such as drug resistance and strong side effects, have prompted the exploration of antibody-drug conjugates (ADCs), which combine targeting capabilities with potent cytotoxins to enhance therapeutic efficacy. Methods We searched PubMed, Cochrane, and EMBASE library databases up to June 8, 2025, for eligible randomized controlled trials (RCTs) and extracted relevant data. The primary outcome measures were overall survival (OS) and progression-free survival (PFS), with subgroup analysis and sensitivity analysis conducted to assess the heterogeneity of statistical results. Results A total of thirteen RCTs involving 5,927 patients were included. The results indicated that ADCs offered superior OS (HR = 0.67, 95%CI: 0.55-0.81) and PFS (HR = 0.76; 95% CI: 0.66-0.86) compared to chemotherapy drugs. The any adverse event (96.8% vs. 93.6%), grade 3-5 adverse event (51.7% vs. 51.8%) and serious adverse event (25.3% vs. 22.4%) caused to patients were generally similar between ADCs and chemotherapy. Conclusion Our meta-analysis demonstrates that compared to chemotherapy drugs, ADC drugs can prolong both OS and PFS in cancer patients, with no significant difference in adverse reactions.
Keywords: Antibody-drug conjugate, chemotherapy, Malignant tumors, Systematic review, Meta-analysis
Received: 02 Sep 2025; Accepted: 12 Dec 2025.
Copyright: © 2025 Gao, 陶, Hao, Wu, Zhu, Lv and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yongsheng Zhang
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