A 59-year-old man was investigated for fever, headache, and blurring of vision. On physical examination, he had hepatosplenomegaly. PET/CT revealed multiple intra-thoracic and intra-abdominal lymphadenopathy. A complete blood count showed leucocytosis (90.4 × 109 /L) with anemia (9.8 g/dL) and thrombocytopenia (77 × 109/L). The peripheral blood smear showed the presence of 75% pleomorphic, medium- to large-sized atypical cells with mostly irregularly shaped nuclei, high nuclear/cytoplasmic ratio, and immature, blastic chromatin with multiple nucleoli (Fig. 1A). Bone marrow examination revealed infiltration by 80% of similar morphology cells. On immunophenotyping, these cells were: CD45bright+/CD2+/CD7+/CD43dim+/CD94+/cytoplasmicCD3−/CD5−/CD28−/CD4−/CD8−/TdT−/CD19−/CD10−/CD117−/CD33−/CD13−/CD56−/Perforin−/TCRαβ−/TCRγδ−/HLA-DR+/cytoplasmicCD79a−/CD30− /CD57− /CD16−/CD11c−/CD25−/cytoplasmic MPO−/CD64− /CD14−. This suggested a diagnosis of Natural Killer (NK) cell lymphoblastic leukemia/lymphoma. The patient was started on cyclophosphamide, dexamethasone, and etoposide. However, he developed tumor lysis syndrome and succumbed to the disease.
Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.