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The payloads used in ADCs are often cytotoxic compounds that are too toxic to be used alone as anticancer drugs. After intravenous administration, only about 2% of ADCs can reach the target tumor site. Therefore, the ADC payload must be a highly active molecule. The optimization of the payload played an important role in increasing the ADC therapeutic window from less than 2 times that of the first generation to 12 times that of the third generation.
