For both ADCs and bispecific antibodies, there is an increasing focus on combination therapies, such as use in combination with chemotherapy, radiotherapy or immunotherapy e.g. checkpoint inhibitors. The success of the Padcev®/Keytruda® combination has built confidence in the pairing of the ADC/checkpoint inhibitor modalities, and there are a large number of active trials for ADC and anti-PD(L)1 combinations. Many clinical trials are also exploring the combination of BiTE bispecific antibodies with checkpoint inhibitors, in the hope of expanding the use of BiTEs into solid tumours and therefore vastly extending the number of patients who could be treated.

Combination therapy may increase efficacy and reduce the likelihood of a tumour cell developing resistance by targeting multiple pathways. However, preclinical and clinical data has so far shown varying success, demonstrating that development of successful combination therapies is far from straightforward and remains a field ripe for innovation.