Table 2.

Main characteristics of different ADCs and their toxicities in multiple myeloma.

Agent	Effector Moiety	Structure	Mechanism of Action	Main Toxicity Profile
Belantamab mafodotin	Monomethyl auristatin F	humanized IgG1 Ab conjugated to a microtubule disrupting agent MMAF	tubulin inhibitor	thrombocytopenia, corneal events [32]
AMG 224	Maytansinoid DM1	comprised of an anti-tubulin inhibitor maytansine derivative conjugated to antibody lysine residues via the non-cleavable 4-(N-maleimidomethyl) cyclohexane-1-carboxylate linker	ubulin inhibitor	Thrombocytopenia grade ≥ 3: 40% ocular AEs grade 1–2: 30% [33]
MEDI2228	Pyrrolo-benzodiazepine	fully human anti-BCMA antibody site-specifically conjugated to a PBD tesirine via a protease-cleavable linker	DNA damage	photophobia without keratopathie or loss of visual acuity (54%), dry eye (20%) thrombocytopenia (32%), pleural effusion (20%) [34]
HDP-101	Amanitin	fully humanized mAb conjugated to amanitin via a non-cleavable MC linker	RNA polymerase II inhibitor	preclinical

Abbreviation: ADC antibody-drug conjugates; DM1: N^2′-deacetyl-N^2′-(3-mercapto-1-oxopropyl)-maytansine; (m)Ab (monoclonal) antibody; MMAF monomethyl auristatin; PBD pyrrolobenzodiazepine.