Oral Toxicities With Antibody-Drug Conjugates: What Physicians Should Know

Antibody-drug conjugates (ADCs) have become an increasingly important part of treatment for several advanced cancers, pairing a tumor-targeting antibody with a cytotoxic payload.

By
October 9, 2026
4 min

Baptist Health South Florida

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In a retrospective multicenter cohort of 207 patients with advanced cancer treated with TROP2- or HER2-directed ADCs, 22.7% developed at least 1 oral toxicity.
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Oral mucositis was more common with TROP2-directed than HER2-directed ADCs (14.8% vs 5.4%), and adjusted odds were approximately 3 times higher with TROP2 therapy.
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Dysgeusia and xerostomia were more common with HER2-directed ADCs, although differences between treatment groups were not statistically significant.
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Topical corticosteroids did not improve existing mucositis or prevent new lesions, whereas 4 patients treated with oral cryotherapy had symptomatic improvement and fewer new ulcers.
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The retrospective design, predominance of patients with breast cancer, and reliance on medical records may limit generalizability and have led to underreporting of oral toxicities.

Oral Toxicities With Antibody-Drug Conjugates: What Physicians Should Know

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Original Source(s)

Oral Toxicities With Antibody-Drug Conjugates: What Physicians Should Know

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