偶联药物研究进展

doi:10.19586/j.2095-2341.2025.0008

生物技术进展 ›› 2025, Vol. 15 ›› Issue (3): 388-395.DOI: 10.19586/j.2095-2341.2025.0008

偶联药物研究进展

杨明明(), 王辉()

华北制药集团新药研究开发有限责任公司，抗体药物研制国家重点实验室，抗体药物河北省工程研究中心，石家庄 052165

收稿日期:2025-01-21 接受日期:2025-04-30 出版日期:2025-05-25 发布日期:2025-07-01
通讯作者: 王辉
作者简介:杨明明 E-mail： 743419974@qq.com；
基金资助:
河北省重点研发计划生物医药创新专项(23372404D)

Research Progress on Coupled Drugs

Mingming YANG(), Hui WANG()

State Key Laboratory of Antibody Research and Development，Hebei Engineering Research Center of Antibody Medicine，North China Pharmaceutical Group New Drug Research and Development Co. ，Ltd. ，Shijiazhuang 052165，China

Received:2025-01-21 Accepted:2025-04-30 Online:2025-05-25 Published:2025-07-01
Contact: Hui WANG

摘要/Abstract

摘要：

抗体偶联药物（antibody-drug conjugate, ADC）临床应用的成功推动了放射性核素偶联药物（radionuclide drug conjugates, RDC）、多肽偶联药物（peptide drug conjugates, PDC）及小分子药物偶联物（small molecule-drug conjugates, SMDC）等新型偶联药物的快速发展。这些药物通过整合靶向递送与高效载荷释放，在癌症治疗领域展现出显著优势，并逐步向疾病诊断与其他治疗领域拓展。系统综述了偶联药物、偶联技术的研究进展与临床转化现状，探讨了其在适应症扩展、技术迭代及诊疗一体化中的未来研究方向。

关键词: 抗体偶联药物, 放射性核素偶联药物, 多肽偶联药物, 小分子药物偶联物, 偶联技术

Abstract:

The clinical success of antibody-drug conjugates （ADCs） has driven the rapid development of novel conjugate drugs， including radionuclide drug conjugates （RDCs）， peptide drug conjugates （PDCs）， and small molecule drug conjugates （SMDCs）. These drugs offer significant advantages in cancer treatment by integrating targeted delivery with efficient payload release and are progressively expanding into disease diagnosis and therapeutic areas beyond oncology. This article systematically reviewed the current landscape of conjugate drugs， coupling technologies， recent progress， and clinical translation， while exploring future directions in expanding indications， technological advancements， and integrated theranostic applications.

Key words: antibody-drug conjugates, radionuclide drug conjugates, peptide drug conjugates, small molecule-drug conjugates, coupled techniques

中图分类号:

Q819

杨明明, 王辉. 偶联药物研究进展[J]. 生物技术进展, 2025, 15(3): 388-395.

Mingming YANG, Hui WANG. Research Progress on Coupled Drugs[J]. Current Biotechnology, 2025, 15(3): 388-395.

图/表 2

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分类	核素类型	代表核素	检测/作用机制
诊断型RDC	正电子（β⁺）发射体	⁶⁸Ga、¹⁸F、⁶⁴Cu^③、⁸⁹Zr	PET显像（γ光子检测）
诊断型RDC	单光子发射体	⁹⁹mTc、¹¹¹In	SPECT显像
治疗型RDC	高LET α粒子^①发射体	²²⁵Ac、²²³Ra、²¹³Bi、²¹¹At	引发DNA双链断裂，杀伤乏氧细胞
治疗型RDC	长射程 β⁻粒子^②发射体	¹⁷⁷Lu^③、⁹⁰Y、¹³¹I、¹⁸⁸Re	交叉火力效应覆盖异质性肿瘤

分类	核素类型	代表核素	检测/作用机制
诊断型RDC	正电子（β⁺）发射体	⁶⁸Ga、¹⁸F、⁶⁴Cu^③、⁸⁹Zr	PET显像（γ光子检测）
诊断型RDC	单光子发射体	⁹⁹mTc、¹¹¹In	SPECT显像
治疗型RDC	高LET α粒子^①发射体	²²⁵Ac、²²³Ra、²¹³Bi、²¹¹At	引发DNA双链断裂，杀伤乏氧细胞
治疗型RDC	长射程 β⁻粒子^②发射体	¹⁷⁷Lu^③、⁹⁰Y、¹³¹I、¹⁸⁸Re	交叉火力效应覆盖异质性肿瘤

药物类型	已上市数量（全球）	技术特点	适应症分布	中国进展	代表药物
ADC药物	16款	靶点多样化(HER2、TROP2、CD79b等)、抗体亚型选择（IgG1/IgG4）、载荷选择（微管蛋白抑制剂/DNA损伤剂）、连接子技术迭代（可裂解/不可裂解）	血液肿瘤（淋巴瘤、白血病等）实体瘤(乳腺癌、前列腺癌等)管线80%集中于实体瘤	10款获批上市（如维迪西妥单抗、德曲妥珠单抗等）多款处于临床Ⅲ期（如Tisotumab vedotin）	德曲妥珠单抗（Enhertu^®）、戈沙妥珠单抗（Trodelvy^®）、维泊妥珠单抗（Polivy^®）等
RDC药物	18款	核素诊疗一体化（如⁶⁴Cu、¹⁷⁷Lu）、连接子工程优化（DOTA-GSC体系）、载体多样化（抗体、多肽、小分子）	肿瘤诊断与治疗（前列腺癌、神经内分泌肿瘤等）拓展至神经退行性疾病（阿尔茨海默病）	¹³¹I-美妥昔单抗（利卡汀^®）获批肝癌治疗，¹⁷⁷Lu-PSMA-617（Pluvicto^®）申请上市	⁶⁸Ga-PSMA-11（LOCAMETZ^®）、¹⁷⁷Lu-DOTATATE（Lutathera^®）、⁹⁰Y-替伊莫单抗（Zevalin^®）等
PDC药物	2款	分子量小（<5 kD）、实体瘤渗透性强、模块化多肽设计、双响应连接子技术	胃肠胰神经内分泌肿瘤、乳腺癌、脑转移等难治性肿瘤	Lutathera^®（镥-177）批准临床，Pepaxto^®撤市后无新药上市	Lutathera^®（¹⁷⁷Lu-DOTATATE）、Pepaxto^®（已撤市）
SMDC药物	0款	组织穿透性佳、靶向难成药靶点（KRAS G12D、AKR1C3等）、载荷多元化（PROTAC等）	实体瘤（胰腺癌、肝细胞癌等）	多款处于Ⅰ/Ⅱ期（如AST-001、CBP-1019）	QHL-108（靶向TOP2）、AST-001（靶向KRAS G12D）等

药物类型	已上市数量（全球）	技术特点	适应症分布	中国进展	代表药物
ADC药物	16款	靶点多样化(HER2、TROP2、CD79b等)、抗体亚型选择（IgG1/IgG4）、载荷选择（微管蛋白抑制剂/DNA损伤剂）、连接子技术迭代（可裂解/不可裂解）	血液肿瘤（淋巴瘤、白血病等）实体瘤(乳腺癌、前列腺癌等)管线80%集中于实体瘤	10款获批上市（如维迪西妥单抗、德曲妥珠单抗等）多款处于临床Ⅲ期（如Tisotumab vedotin）	德曲妥珠单抗（Enhertu^®）、戈沙妥珠单抗（Trodelvy^®）、维泊妥珠单抗（Polivy^®）等
RDC药物	18款	核素诊疗一体化（如⁶⁴Cu、¹⁷⁷Lu）、连接子工程优化（DOTA-GSC体系）、载体多样化（抗体、多肽、小分子）	肿瘤诊断与治疗（前列腺癌、神经内分泌肿瘤等）拓展至神经退行性疾病（阿尔茨海默病）	¹³¹I-美妥昔单抗（利卡汀^®）获批肝癌治疗，¹⁷⁷Lu-PSMA-617（Pluvicto^®）申请上市	⁶⁸Ga-PSMA-11（LOCAMETZ^®）、¹⁷⁷Lu-DOTATATE（Lutathera^®）、⁹⁰Y-替伊莫单抗（Zevalin^®）等
PDC药物	2款	分子量小（<5 kD）、实体瘤渗透性强、模块化多肽设计、双响应连接子技术	胃肠胰神经内分泌肿瘤、乳腺癌、脑转移等难治性肿瘤	Lutathera^®（镥-177）批准临床，Pepaxto^®撤市后无新药上市	Lutathera^®（¹⁷⁷Lu-DOTATATE）、Pepaxto^®（已撤市）
SMDC药物	0款	组织穿透性佳、靶向难成药靶点（KRAS G12D、AKR1C3等）、载荷多元化（PROTAC等）	实体瘤（胰腺癌、肝细胞癌等）	多款处于Ⅰ/Ⅱ期（如AST-001、CBP-1019）	QHL-108（靶向TOP2）、AST-001（靶向KRAS G12D）等

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Research Progress on Coupled Drugs

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