Antibody drug conjugates (ADCs) have firmly established themselves as one of the most strategically important modalities in global biopharma R&D. According to the IQVIA Institute Global R&D Trends 2026 Report: Advancing Innovation in a Changing Landscape, ADCs are driving sustained growth in deal activity, expanding clinical pipelines, and reshaping how sponsors approach targeted cancer therapy.

As oncology development becomes more competitive and precision expectations increase, ADCs are increasingly viewed as a scalable and clinically validated way to deliver potent therapies with improved selectivity.

Why ADC momentum continues to build

At its core, the ADC construct brings together three elements: a target binding molecule - which may take the form of a full antibody, a fragment, or another engineered binder, a linker whose properties can be tuned to control how the system holds together and releases its cargo, and a cytotoxic payload drawn from different classes of potent agents.

While only a small fraction of the payload ultimately reaches tumor cells directly, the design still enables preferential delivery to cancer tissue, complemented by additional mechanisms such as passive diffusion, bystander effects, and immune mediated activity — including ADCC — that together contribute to antitumor efficacy. This means that both efficacy and toxicity arise from the integrated behavior of the system in vivo, rather than from target cell delivery alone. For developers, understanding and controlling these mechanisms is essential — not only to define clinically meaningful efficacy parameters and inform biomarker strategies and target population selection, but also to manage specific side effects, improve tolerability, and ultimately translate insight into competitive advantage.

The 2026 report notes that ADCs have moved beyond proof of concept. They are now an established therapeutic class with a growing number of approvals and a rapidly expanding pipeline. Improvements in linker technology, payload diversity, and target selection have helped address earlier safety and efficacy limitations, supporting broader sponsor confidence.

At the same time, ADCs offer a familiar biological foundation for companies already experienced with monoclonal antibodies, reducing barriers to entry compared with more novel or infrastructure intensive modalities.

Deal activity reflects strategic commitment

One of the clearest signals of ADC importance is the scale and consistency of dealmaking activity. The Global R&D Trends 2026 Report identifies ADCs as one of the drug modalities with the strongest growth in deal volume since 2019, alongside radiopharmaceuticals (RPTs) and oligonucleotides.

ADC focused partnerships, licensing agreements, and acquisitions have increased substantially over this period, with both emerging biopharma and large pharmaceutical companies actively participating. These deals span early discovery platforms through late stage assets, indicating confidence across the development lifecycle.

Importantly, ADC transactions are not confined to experimental oncology niches. Many are centered on broadly prevalent tumor types where sponsors are seeking differentiation rather than first in class novelty.

Oncology leads, but platform ambition is broader

Oncology remains the dominant focus for ADC development, and the IQVIA Institute reports that novel modalities now account for a growing share of oncology trial starts globally. In 2025, one third of oncology trials involved novel drug modalities, including ADCs, RPTs, multi-specific antibodies, and cell and gene therapies.

Within oncology, ADC pipelines span both solid and hematologic malignancies. Targets include both well established antigens and a growing set of novel or tumor specific markers. Some are predefined based on prior biological and clinical validation, while others are newly identified — or reevaluated in the context of an expanding and increasingly diversified target landscape. Across both categories, targets are prioritized based on high tumor specificity, limited expression in normal tissues, and relevance across heterogeneous disease settings. This combined approach — leveraging known biology while continuously expanding and refining the target repertoire — is central to improving the therapeutic index and broadening the scope of addressable tumors.

Beyond oncology, ADC platform technologies are increasingly being evaluated for potential application in other therapeutic areas, reflecting growing sponsor interest in extending the modality’s reach where unmet need and biological rationale align.

ADCs anchor the broader modality shift

While small molecules still represent the largest share of biopharma development overall, the report highlights ADCs as one of the modalities driving meaningful change in R&D strategy. Since 2019, ADCs have shown some of the most pronounced growth in deal activity and clinical trial presence among non traditional drug classes.

This reflects a deliberate pivot by sponsors toward modalities that offer both differentiation and scalability. ADCs occupy a middle ground between traditional biologics and more complex next generation therapies, combining proven antibody platforms with enhanced potency.

For many organizations, ADCs now serve as a cornerstone of oncology portfolio strategy rather than a supplemental investment.

Execution complexity remains a differentiator

Despite their maturity, ADC development is not without challenges. The IQVIA Institute notes that increasing use of complex modalities has implications for clinical development and operations.

For ADCs, this includes, as previously mentioned, managing payload related toxicity, optimizing dosing strategies, ensuring manufacturing consistency, and selecting trial populations that balance efficacy with safety. As pipelines grow more crowded, differentiation increasingly depends on execution precision as much as science.

Sponsors are placing greater emphasis on biomarker strategies, patient selection, and trial design to accelerate timelines and reduce late stage risk. This has also increased demand for development partners with deep oncology and biologics experience.

Strategic takeaways for sponsors

The Global R&D Trends 2026 analysis makes clear that ADCs are no longer emerging technologies. They are established, competitive, and central to oncology R&D planning.

Competition for high quality targets and differentiated payload technologies is intensifying. As a result, sponsors are investing earlier in platform capabilities and seeking partnerships that can support end to end development.

Execution excellence, including smart trial design and operational readiness, has become a key source of advantage as ADC pipelines mature.

What comes next

Looking ahead, the IQVIA Institute positions ADCs as one of the most durable growth areas within oncology. Continued deal activity, rising clinical trial volumes, and expanding sponsor participation all point to sustained momentum.

Future progress will likely be shaped by advances in next generation ADC designs, including new payload classes, improved linkers, and combination strategies with other targeted modalities.

As oncology innovation accelerates, ADCs are expected to remain a foundational modality, enabling sponsors to balance precision, potency, and scalability in an increasingly complex R&D environment.

This blog is based on insights from The IQVIA Institute’s Global R&D Trends 2026 Report: Advancing Innovation in a Changing Landscape. For more report information, please visit https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/global-r-and-d-trends-2026.