Past exam of the biochemistry and Molecular Biology course of the University of Cambridge / 2025 / Paper 2 / Section A / 9 / Solution

An antibody-drug conjugate couples an antibody against a tumor-associated surface antigen to a potent cytotoxic payload through a suitable chemical linker. Binding enriches delivery to biological cells displaying the target. Many designs undergo receptor-mediated endocytosis, trafficking through endosomes to a lysosome, and release of an active drug through linker cleavage or degradation of the antibody. The released payload can disrupt microtubules or damage DNA, killing the target biological cell. Specificity comes from targeted delivery combined with controlled payload release. It is relative rather than absolute: normal biological cells may share the antigen, and a membrane-permeable released payload can also affect neighboring biological cells. Successful action therefore depends on antigen abundance, accessibility, internalization, linker stability and payload sensitivity.