OnCo
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ADC + checkpoint inhibitor

An ADC kills tumour cells in a way that alerts the immune system; a checkpoint inhibitor lets the immune system finish the job.

Proven in urothelial cancer (EV-302: enfortumab vedotin + pembrolizumab, OS HR 0.47) and TNBC (ASCENT-04: sacituzumab govitecan + pembrolizumab, PFS HR 0.65, approved 2026). TROPION-Breast05 (Dato-DXd + durvalumab) and multiple lung trials follow. Overlapping pneumonitis risk with DXd ADCs needs care.

Rationale
TOP1 and tubulin payloads induce immunogenic cell death, cGAS-STING activation, and antigen release; ADCs also deplete immunosuppressive myeloid cells. PD-1 blockade converts the resulting T-cell priming into durable control.
Evidence
Phase 3 positive in two tumour types; multiple ongoing.

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