Clinical Strategies for the Assessment and Management of Antibody-Drug Conjugate Toxicities

Sri Kota, MSN, BA, APN, AGNP-C, AOCNP, Rutgers Cancer Institute, New Brunswick, New Jersey, presented a comprehensive overview focused on recognizing and managing toxicities associated with antibody-drug conjugates (ADCs), including practical guidance on toxicity grading, symptom management, and strategies to optimize adherence and patient outcomes, at the 2025 Oncology Learning Network APP Institute.

The talk reviewed ADC mechanisms of action, the expanding role of these agents across solid and hematologic malignancies and emphasized that most toxicities are driven by the cytotoxic payload, requiring familiarity with payload class, linker design, and drug-antibody ratio. 

Transcript:

Hi. My name is Sri Kota and I'm a nurse practitioner at the Robert Wood Johnson-Barnabas Health Morris Cancer Center and Rutgers Cancer Institute in New Jersey. I've been in oncology nursing for almost 20 years, predominantly in the ambulatory setting. My experience includes both solid tumors and hematologic malignancies. I have worked in infusion breast medical oncology clinic, and now I work in the GU Medical Oncology tumor group.

I had the opportunity to present at the recent Oncology Learning Network APP Institute event in December 2025. My topic of presentation was managing toxicities associated with antibody drug conjugates (ADC). In this presentation, we went over the basics, introduction to ADCs, mechanism of action, the role of ADCs and cancer therapy, mechanisms of toxicity, the most common toxicities and essential tools to recognize and manage them.

Some key takeaways from this discussion are ADCs are expanding rapidly across solid tumors and hematologic malignancies. Initially, this category was mostly in the metastatic setting, but is now being used in the neoadjuvant, adjuvant and first-line settings.

Toxicities and adverse events are mostly related to the cytotoxic payload—it is important to know the details of each ADC, such as payload class, drug antibody ratio, and information on the linkers. We went over each toxicity in detail with symptoms, grading information for assessment and recommended interventions.

Finally, we talked about things to do to optimize adherence and patient outcomes. We finally ended the session with a Q&A session with the audience. 

Source: 

Kota S. Managing Toxicities Associated with Antibody-Drug Conjugates. Presented at Oncology Learning Network APP Institute; December 18-19, 2025. Virtual.