BIO 2026: Improving ADC Tolerability Could Expand Long-Term Cancer Treatment Options

As antibody-drug conjugates continue to advance across oncology, developers are increasingly focused on improving tolerability alongside efficacy. At the BIO International Convention 2026, in San Diego, CA, June 22-25, Sabeen Mekan, MD, senior vice president and chief medical officer, Zymeworks, Inc, will discuss how advances in ADC design could help patients remain on treatment longer while maintaining quality of life. Her panel, entitled: The Next Generation of ADCs: Building Kinder, Gentler Cancer Therapeutics focuses on the future of antibody-drug conjugates (ADCs), including advances in linker technology, novel payloads, improved tumor selectivity, and strategies to reduce toxicity while maintaining efficacy.

How are next-generation ADCs being designed to improve tolerability?

During an interview with BioPharm International ahead of the BIO international Convention this year, Dr. Mikan discussed the evolving priorities in cancer drug development and the growing emphasis on treatment tolerability.

According to Mekan, oncology drug development has historically focused on maximizing efficacy, often accepting significant toxicity because patients had limited treatment options. However, as therapies become more effective and are used earlier in treatment, patient experience is becoming increasingly important.

"The goal is to make cancer a chronic disease," the Dr. Mekan said. "Then tolerability becomes very, very important."

The discussion centered on antibody-drug conjugates (ADCs), which combine tumor-targeting antibodies with potent cytotoxic payloads. While ADCs have expanded treatment options for many cancers, adverse events such as nausea and vomiting can remain burdensome, particularly for patients who may remain on therapy for extended periods.

Dr. Mekan highlighted several areas of innovation aimed at improving the therapeutic index of ADCs. One focus is the development of more precise conjugation methods that reduce variability in drug-to-antibody ratios, potentially improving dose predictability and reducing toxicity.

Researchers are also exploring less toxic payloads that maintain anti-tumor activity at lower doses. In addition, advances in antibody engineering may improve targeting and internalization into cancer cells.

"You can have the same linker and payload," Dr. Mekan explained, "but having a better internalizing antibody is going to make the ADC much more effective and targeted to cancer cells."

Together, these advances may help create more tolerable cancer therapies that patients can remain on for longer periods while maintaining everyday activities and quality of life.

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About the speaker

Sabeen Mekan, MD, Senior VP and chief medical officer, Zymeworks, Inc.

Dr. Priyanka Mekan is Senior Vice President and Chief Medical Officer at Zymeworks, a position she has held since April 2025. She brings extensive experience in oncology drug development, having previously held leadership roles at Gilead Sciences, Daiichi Sankyo, and Bristol Myers Squibb. Prior to joining industry, she served as an assistant professor and practicing hematologist/oncologist in New York. Board certified in internal medicine, oncology, and hematology, Dr. Mekan has led the development of multiple cancer therapies and authored numerous scientific publications.