Antibody drug conjugates in Alzheimer's disease: emerging strategies and future directions.

Antibody-drug conjugates (ADCs) are emerging as a targeted therapeutic strategy for Alzheimer's disease (AD), offering precise delivery of disease modifying agents with reduced systemic toxicity. By linking monoclonal antibodies to small-molecule payloads, ADCs hold promise in overcoming key challenges in AD treatment, including poor blood-brain barrier (BBB) penetration and off-target effects. This review provides a critical synthesis of ADC strategies in neurodegeneration, with emphasis on molecular design, payload selection, and delivery mechanisms. Distinctively, we integrate lessons from oncology-based ADC development into the neurodegenerative context, highlighting how these cross disciplinary insights open new avenues for tackling multifactorial AD pathology, including amyloid-beta (Aβ) and tau-related mechanisms. By outlining translational progress, ongoing clinical efforts, and future directions, this review positions ADCs not only as a promising precision medicine approach but also as a novel framework for advancing therapeutic innovation in complex neurodegenerative disorders.