尽管通过批准检查点和PARP抑制剂成为标准治疗，治疗宫颈癌、卵巢癌和子宫癌方面已取得重大进展，但复发转移的妇科恶性肿瘤患者仍然面临着不良后果，并且这些患者大多会出现疾病复发。一旦标准优先治疗方法失效，历史上可选择的治疗方法有限，通常与不良后果和显著毒性相关。因此，对于复发和转移的妇科恶性肿瘤患者，需要具有有效性和良好耐受性的新型治疗方法。抗体药物偶联物（ADC）是一类针对性治疗方法，在多种癌症中已得到良好应用，包括血液恶性肿瘤和一些实体肿瘤。ADC技术和设计方面取得的重大进展已经改善了新一代ADC的疗效和安全性。因此，ADC在妇科癌症领域正获得越来越多的关注，例如近期美国食品和药物管理局批准tisotumab vedotin用于治疗宫颈癌和mirvetuximab soravtansine用于治疗卵巢癌。目前正在研究多种针对不同目标的ADC用于治疗转移或复发的妇科恶性肿瘤。本文的目的是总结ADC的细微结构和功能特性，并概述创新机会。此外，我们还突出介绍正在临床开发用于妇科恶性肿瘤的ADC，探讨ADC如何能够填补妇科癌症患者临床护理方面的差距。版权所有 © 2023 Elsevier Ltd.

Despite significant advances in the treatment of cervical, ovarian, and uterine cancers with the approvals of checkpoint and PARP inhibitors into standard treatment, patients with recurrent metastatic gynecologic malignancies still experience poor outcomes, and most of these patients will experience disease relapse. Once standard preferred treatments are exhausted, options have historically been limited to treatments associated with poor outcomes and notable toxicities. Consequently, novel therapies that are effective and well-tolerated are needed for patients with recurrent and metastatic gynecologic malignancies. Antibody-drug conjugates (ADCs) are a class of targeted therapies that are well established in several cancers including hematologic malignancies and some solid tumors. Significant strides in ADC technology and design have led to improvements in efficacy and safety with newer-generation ADCs. Consequently, ADCs are gaining traction in gynecologic cancers with the recent US Food and Drug Administration approvals of tisotumab vedotin in cervical cancer and mirvetuximab soravtansine in ovarian cancer. Many additional ADCs against various targets are being explored in patients with metastatic or recurrent gynecologic malignancies. The purpose of this review is to summarize the nuanced structural and functional properties of ADCs, while outlining opportunities for innovation. Further, we highlight the ADCs in clinical development for gynecologic malignancies, exploring how ADCs may be able to address the clinical care gap for patients with gynecologic cancers.Copyright © 2023 Elsevier Ltd. All rights reserved.