How Linker Innovation Could Shape the Next Generation of Antibody–Drug Conjugates

Antibody–drug conjugates (ADCs) continue to gain momentum across oncology, driven by advances in targeting strategies, payload technologies, and linker chemistry. As developers look to improve therapeutic precision while minimizing toxicity, attention is increasingly shifting toward how these components work together to optimize drug delivery. During the 2026 BIO International Convention last month, BioPharm International® spoke with Paul Romness, chair, chief executive officer, and president of OS Therapies, about emerging trends in ADC design, evolving regulatory considerations for rare cancers, and where he believes the field is headed next.

BioPharm International: ADCs have become one of the fastest-growing areas in oncology. Where do you think the field is today?

Romness: I think ADCs are where monoclonal antibodies were about 10 years ago. If you look ahead another seven to 10 years, I think ADCs will become one of the dominant therapeutic modalities in oncology.

As with any emerging technology, we've seen a lot of companies pursuing similar approaches over the past several years. The science has advanced tremendously, but I think we're now entering the stage where differentiation becomes increasingly important. Developers are looking beyond simply identifying a target and are asking how they can improve delivery, safety, and patient outcomes.

As ADC technology continues to mature, where do you see the greatest opportunity for innovation?

People often focus on the antibody or the payload, but I think linker technology deserves just as much attention.

The linker is responsible for ensuring the payload reaches the tumor while limiting exposure to healthy tissue. In many ways, it's the weakest link in an ADC, because if the payload is released too early or in the wrong place, you lose precision and potentially increase toxicity.

I think we'll continue to see significant innovation around linker chemistry because improving where and when the payload is released has the potential to improve both efficacy and safety.

How is the industry thinking differently about payload delivery?

The goal is becoming much more precise delivery.

I often compare traditional chemotherapy to moving a piano through a house. If you don't protect it, you're going to bump into every wall on the way to its destination. That's similar to what happens with many traditional chemotherapies. They're effective, but healthy tissues are exposed along the way.

The ideal ADC delivers its payload only where it's needed. As delivery technologies continue to improve, I think we'll see therapies become increasingly selective while reducing unwanted effects on healthy tissue.

Beyond linker design, what other advances do you expect to influence the next generation of ADCs?

I think we'll continue to see more sophisticated payload strategies.

Today, most ADCs are designed around a single payload, but I think there's an opportunity to begin exploring multiple payloads within the same construct. That could allow developers to target tumors through different mechanisms simultaneously while still maintaining the precision that makes ADCs attractive in the first place.

Those are the kinds of engineering advances that could continue moving the field forward over the next decade.

Rare cancers often present unique development and regulatory challenges. How do those realities influence innovation?

Rare diseases require a different perspective because patient populations are so small and treatment options are often limited.

When you're developing therapies for aggressive rare cancers, regulators are trying to balance the need for strong clinical evidence with the reality that patients have very few alternatives. That's where biomarkers, long-term follow-up, and well-designed confirmatory studies become especially important.

I think we'll continue to see discussions around how accelerated development pathways can be used appropriately while still maintaining confidence in the data.

What broader trend are you watching most closely in oncology drug development?

One of the most encouraging developments is greater collaboration among regulatory agencies.

We've seen increasing communication between organizations like the FDA and the UK's Medicines and Healthcare products Regulatory Agency. Greater alignment across regulatory agencies has the potential to create more consistent development pathways, which is especially important for companies developing therapies for rare diseases.

From a broader perspective, I also think the industry will continue moving toward technologies that improve precision. Whether that's through better targeting, more sophisticated payloads, or advances in linker chemistry, the goal is the same. We want to deliver therapies where they're needed while minimizing unnecessary exposure elsewhere in the body. I think that's where the next generation of ADC innovation is headed.