A large, real-world study by pharmacy researchers at the University of California, Irvine has uncovered serious blood-related side effects associated with antibody-drug conjugates, an increasingly important targeted cancer therapy. Over the years, many new ADC therapies have been approved for the treatment of various types of cancer.
Research published in journals canceranalyzed treatment data from 3,511 patients across six University of California medical centers. They found that some ADCs are associated with significant rates of severe neutropenia (dangerously low levels of infection-fighting white blood cells) and associated complications, including febrile neutropenia, a potentially life-threatening condition that involves hospitalization, intensive care unit admission, fever and risk of infection.
The effort was led by researchers from the School of Pharmacy and Pharmacy and UCI Health, including corresponding author Professor Alexander Chan and Director of Clinical Pharmacy Practice.
ADCs are designed to deliver chemotherapy directly to cancer cells with minimal damage to healthy tissue. Although treatment outcomes for some cancers, including breast and blood cancers, have improved, the risk of severe neutropenia and infection-related complications varies widely depending on the drug used, the study found.
Our findings demonstrate that while antibody-drug conjugates hold great promise for cancer patients, clinicians must remain vigilant about potentially serious hematologic toxicities. By using real-world data, we will be able to better understand how these treatments impact diverse patient populations outside of the controlled environment of clinical trials. ”
Alexandre Chan, Professor and Director of Clinical Pharmacy Practice, University of California, Irvine
Researchers evaluated 10 commonly used FDA-approved ADCs using data collected between 2012 and 2024 through the University of California Health Data Warehouse. The analysis showed that certain treatments were associated with particularly high rates of hematologic toxicities, such as febrile neutropenia and severe neutropenia, and that underlying medical conditions such as anemia and immunodeficiency disorders increased patients’ risk of complications.
The study also highlighted the importance of large-scale health system data to improve supportive cancer care and identify patients who may benefit from early monitoring and preventive intervention.
“As these targeted therapies become more widely used, it becomes increasingly important to understand and predict side effects,” Zhang said. “This research will help inform safer treatment strategies and improve patient outcomes.”
The study involved collaboration between researchers at the University of California, Irvine, UCI Health, the University of Washington, and the broader University of California Health System.
sauce:
University of California, Irvine
Reference magazines:
Jean, T. Others. (2026). Incidence of clinically significant neutropenia and complications associated with antibody-drug conjugates: A real-world study at the University of California. cancer. DOI: 10.3390/Cancer18101563. https://www.mdpi.com/2072-6694/18/10/1563

