The antibody-drug conjugate (ADC) market achieved a significant milestone in 2023, surpassing US$10 billion in sales for the first time. This momentum continued into 2024, with several key drugs experiencing substantial revenue growth.

Currently, 17 ADC drugs have been approved globally. Among them, Enhertu leads the market with sales of $3,754m. Furthermore, recently approved ADC drugs, such as Sacituzumab tirumotecan (approved in China) and Datroway (datopotamab deruxtecan), have demonstrated strong market potential, indicating a promising future for the ADC market.

Table 1. Sales of ADCs in 2024

Enhertu Sales in 2024

Enhertu (trastuzumab deruxtecan) is a specifically engineered HER2-directed DXd ADC jointly developed and commercialised by AstraZeneca and Daiichi Sankyo. It consists of a cytotoxic topoisomerase I inhibitor, DXd, conjugated to the HER2 antibody trastuzumab via a cleavable tetrapeptide linker.

Combined sales of Enhertu, recorded by Daiichi Sankyo and AstraZeneca, amounted to $3,754 million in FY 2024 (FY 2023: $2,566 million).[1] This growth is primarily attributed to its strong performance in second-line treatment of HER2-positive breast cancer and its expanding indications in HER2-low expressing breast cancer.

Figure 1. Sales of Enhertu in FY 2024 [1]

In January 2025, Enhertu was approved by the U.S. Food and Drug Administration (FDA) for treating adult patients with unresectable or metastatic hormone receptor (HR)-positive, HER2-low or HER2-ultralow breast cancer. This approval was primarily based on positive results from the DESTINY-Breast06 Phase III trial. In this trial, Enhertu demonstrated a median progression-free survival (PFS) of 13.2 months compared to 8.1 months in the chemotherapy group, representing a 36% reduction in the risk of disease progression or death. The confirmed objective response rate (ORR) was 62.6% in the Enhertu group, significantly higher than the 34.4% observed in the chemotherapy group. Additionally, a higher proportion of patients in the Enhertu group achieved 12-month overall survival (OS) (87.0% vs. 81.1%, HR=0.81). [2]

Enhertu is currently being evaluated in multiple clinical trials globally to further explore its potential in HER2-positive gastric cancer and other cancers, including first-line treatment of HER2+ gastric cancer (DESTINY-Gastric05). Furthermore, Enhertu's clinical development program includes trials investigating its use in combination with other anti-tumor therapies, such as immunotherapy.

Kadcyla Sales in 2024

Kadcyla (ado-trastuzumab emtansine) is the first FDA-approved ADC for HER2-positive metastatic breast cancer. It comprised of the humanised, monoclonal, anti-HER2 antibody trastuzumab conjugated via a non-cleavable maleimidomethyl cyclohexane-1-carboxylate (MCC) thioether linker to the highly potent cytotoxin DM1.

The approval of Kadcyla in 2013 was a big win for Roche. In 2019, annual sales surpassed US$1 billion, deeming Kadcyla the first ADC to achieve blockbuster status. In 2023, its revenue reached CHF 1,966 million (approximately US$2,280 million). According to Roche's recent 2024 financial report, Kadcyla's global sales in 2024 were CHF 1,998 million (approximately US$2,317 million) (Figure 2). Sales of Kadcyla increased by 7%, with the main growth driver being the International region, notably China. [3]

Figure 2. Kadcyla's global sales in 2024 [3]

Padcev Sales in 2024

Padcev, developed jointly by Astellas and Seagen (later acquired by Pfizer), is a first-in-class ADC drug targeting Nectin-4. It selectively kills cancer cells by delivering the chemotherapy drug monomethyl auristatin E (MMAE) inside the cancer cells by targeting the Nectin-4 protein.

Padcev was initially granted accelerated approval by the U.S. FDA in December 2019, followed by full FDA approval in July 2021 for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC) who have previously received PD-1/PD-L1 inhibitors and platinum-based chemotherapy. In December 2023, the FDA approved Padcev in combination with pembrolizumab (Keytruda) for the first-line treatment of adult patients with locally advanced or metastatic urothelial carcinoma (la/mUC).

Since its full FDA approval in 2021, Padcev has rapidly gained market share. Its global sales reached US$757 million in 2022, US$730 million in 2023, and US$1,588 million in 2024. [4]

Figure 3. Padcev 's and Adcetris’s global sales in 2024 by Pfizer [4]

Adcetris Sales in 2024

Adcetris (brentuximab vedotin) is an ADC product originally developed by Seagen that targets CD30. In 2009, Seagen and Takeda Pharmaceutical entered into an agreement granting Takeda commercialization rights for Adcetris outside the United States and Canada.

Adcetris is an anti-CD30 antibody conjugated via a protease-cleavable linker to the potent anti-microtubule agent MMAE. It was first approved by FDA in 2011 for Hodgkin lymphoma (HL) and anaplastic large cell lymphoma (ALCL). In 2021, Adcetris was also approved by the European Union as a first-line treatment for CD30-expressing sALCL, making it the first ADC globally for first-line treatment.  

On February 12, 2025, ADCETRIS, in combination with lenalidomide and rituximab, was approved to treat adults with diffuse large B-cell lymphoma (DLBCL) that has come back (relapsed) or didn’t respond (refractory) to 2 or more prior treatments and who are not candidates for stem cell transplant (HSCT) or CAR-T therapy.

Adcetris global sales are comprised of sales reported by Pfizer and Takeda Pharmaceutical.  Pfizer's recent financial reports indicate Adcetris sales of US$1,089 million in 2024 (Figure 3). [4] Takeda reported JPY 99.6 billion in Adcetris sales for the first three quarters of fiscal year 2024,[5] which, along with JPY 25.2 billion in Q1 2024 (Q4 of fiscal year 2023),[6] suggests full-year 2024 sales of approximately JPY 124.8 billion (approximately US$822 million). Therefore, total global Adcetris sales for 2024 were US$1,911 million.

Trodelvy Sales in 2024

Gilead's Trodelvy, a novel Trop-2 ADC, generated US$1,315 million in sales in 2024 (increase 24% compared to 2023). [6]

Figure 4. Trodelvy's global sales in 2024 [6]

The FDA currently approves Trodelvy for the treatment of:

• ◆ Metastatic triple-negative breast cancer (mTNBC) in patients who have received at least two prior systemic therapies, including at least one for metastatic disease.
• ◆ Metastatic urothelial cancer (mUC) in patients who have received prior platinum-based chemotherapy and immunotherapy.
• ◆ HR+/HER2- metastatic breast cancer in patients who have received prior endocrine therapy and ≥2 lines of systemic therapy.

Trodelvy also received Breakthrough Therapy designation from the FDA in December 2024 for the treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC) whose disease has progressed on or after platinum-based chemotherapy. This designation is based on results from the ES-SCLC cohort of the global Phase 2 TROPiCS-03 study, which demonstrated encouraging results with Trodelvy as a second-line treatment for ES-SCLC. [7]

While Trodelvy maintains a leading position in the second-line treatment of metastatic triple-negative breast cancer, it will face strong competition from emerging ADCs such as Enhertu and Datroway.

Polivy Sales in 2024

Polivy (polatuzumab vedotin) is the world's first approved ADC drug targeting CD79b, developed by Roche. It conjugates the cytotoxic MMAE with the CD79 antibody polatuzumab via a cleavable linker. It was approved in the United States in June 2019 for the treatment of diffuse large B-cell lymphoma (DLBCL).

According to Roche's recent 2024 annual report, Polivy's global sales in 2024 reached CHF 1,121 million (approximately US$ 1,300 million), an increase of approximately 34% year-over-year. [3]

​

Figure 5. Trodelvy's global sales in 2024 [6]

In April 2023, Polivy received FDA approval in combination with R-CHP (rituximab, cyclophosphamide, doxorubicin, and prednisone) for the first-line treatment of diffuse large B-cell lymphoma (DLBCL).

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References:
[1] https://www.astrazeneca.com/content/dam/az/PDF/2024/fy/Full-year-and-Q4-2024-results-announcement.pdf
[2] https://www.drugs.com/newdrugs/enhertu-approved-first-her2-directed-therapy-patients-her2-low-her2-ultralow-metastatic-breast-6443.html
[3] https://assets.roche.com/f/176343/x/38d96ed8ec/fb24e.pdf
[4] https://s28.q4cdn.com/781576035/files/doc_financials/2024/q4/Q4-2024-PFE-Earnings-Release-Final.pdf  Pfizer Reports Strong Full-Year 2024 Results And Reaffirms 2025 Guidance
[5] https://assets-dam.takeda.com/image/upload/v1738203951/Global/Investor/Financial-Results/FY2024/Q3/qr2024_q3_er_en.pdf
[5] https://assets-dam.takeda.com/image/upload/v1715219694/Global/Investor/Financial-Results/FY2023/Q4/qr2023_q4_f_en.pdf  
[6] https://www.gilead.com/news/news-details/2025/gilead-sciences-announces-fourth-quarter-and-full-year-2024-financial-results
[7] https://www.gilead.com/news/news-details/2024/us-fda-grants-breakthrough-therapy-designation-to-trodelvy-sacituzumab-govitecan-hziy-for-second-line-treatment-of-extensive-stage-small-cell-lung-cancer
[8] https://investors.abbvie.com/static-files/db848c7a-c2f9-4805-9978-f4f714fcaa33
[9] https://www.gsk.com/media/11776/fy-2024-results-announcement.pdf