RT Journal Article SR Electronic T1 Homogeneity of antibody-drug conjugates critically impacts the therapeutic efficacy in brain tumors JF bioRxiv FD Cold Spring Harbor Laboratory SP 2021.12.23.474044 DO 10.1101/2021.12.23.474044 A1 Yasuaki Anami A1 Yoshihiro Otani A1 Wei Xiong A1 Summer Y. Y. Ha A1 Aiko Yamaguchi A1 Ningyan Zhang A1 Zhiqiang An A1 Balveen Kaur A1 Kyoji Tsuchikama YR 2021 UL http://biorxiv.org/content/early/2021/12/24/2021.12.23.474044.abstract AB Glioblastoma multiforme (GBM) is characterized by aggressive growth and the poorest prognosis of all brain tumor types. Most therapies rarely provide clinically meaningful improvements in outcomes of patients with GBM. Antibody-drug conjugates (ADCs) are emerging chemotherapeutics with stunning success in cancer management. Although promising, clinical studies of three ADCs for treating GBM, including Depatux-M, have been discontinued because of safety concerns and limited therapeutic benefits. Here, we report that ADC homogeneity is a critical parameter to maximize the therapeutic potential in GBM therapy. We demonstrate that homogeneous conjugates generated using our linker show enhanced drug delivery to intracranial brain tumors. Notably, compared to heterogeneous ADCs, including a Depatux-M analog, our ADCs provide greatly improved antitumor effects and survival benefits in orthotopic brain tumor models, including a patient-derived xenograft model of GBM. Our findings warrant the future development of homogeneous ADCs as promising molecular entities toward cures for intractable brain tumors.Competing Interest StatementY.A., N.Z., Z.A., and K.T. are named inventors on a patent application relating to the work filed by the Board of Regents of the University of Texas System (PCT/US2018/034363; US-2020-0115326-A1; EU18804968.8-1109/3630189). The remaining authors declare no competing interests.