Antibody drug conjugates (ADCs) continue to be a strong growth area, but next-generation drug conjugates, encompassing oligonucleotides, peptides, and other small-molecule payloads, are on the rise.  

By Patricia Van Arnum, Editorial Director, DCAT, [email protected] 

Next-generation drug conjugates 
While antibody-drug conjugates (ADCs) are an established and growing market, the up-and-coming player in the conjugated drug market are so-called “next-generation” drug conjugates (XDCs). XDCs incorporate a wide range of payloads, linkers, and targeting modalities, which enables highly selective delivery of therapeutic agents to diseased tissues or sites while potentially minimizing off-target side effects and enhancing the therapeutic window and potency, thereby allowing developers to create more advanced and site-targeted therapeutic options. The ascent of XDCs is driven by the ongoing innovations in payload types (oligonucleotides, peptides, and small molecules), linker optimization, and conjugation platforms that improve stability and control release. 

This therapeutic potential is driving growth in the market and in the industry’s pipeline. The XDC market was valued at $8.0 billion in 2025 and is projected to reach $11.2 billion in 2026 and $26.2 billion by 2035, representing a compound annual growth rate (CAGR) of 9.9% from 2026 to 2035, according to a recent study, Next-Generation Drug Conjugates Market, by Roots Analysis, a business intelligence firm serving the bio/pharmaceutical industry. For purposes of its analysis, the firm includes in its scope of XDCs: ligand mediated RNAi conjugates, ligand conjugated antisense medicines, peptide-radionuclide conjugates, small-molecule drug conjugates, virus-like drug conjugates, and radioconjugates. 

“The market for next-generation drug conjugates has evolved quite fast,” says Gaurav Chaudhary, CEO, Roots Analysis, a business intelligence firm serving the bio/pharmaceutical industry, in the latest episode of the DCAT Value Chain Insights podcast, Production to Prescription. “I believe the growth rate of the next-generation drug conjugates market is going to be a little bit higher than the ADCs market. It is a very interesting space, and a lot of new things are happening with these types of conjugates.”   

These happenings include the rise of some key commercial products and increased partnerships and clinical trial activity that are driving drug development of XDCs. Currently close to 220 clinical trials are ongoing / completed in the XDC space, according to the Roots Analysis study. Nearly 80% of these trials are in the early phase of development. The majority of these clinical trials are being initiated in North America, followed by Europe. Most of the trials were registered in the second half of 2025, and more than 70% are recruiting patients for these clinical trials. Over 85% of the partnerships for XDCs were formed over the past five years.  

Like ADCs, oncology is a leading therapeutic sector of XDCs, projected to account for nearly 28% of the XDC market by 2035, second only to a broader therapeutic category, genetic disorders (see Figure 1), according to the Roots Analysis study.  

The leading types of XDCs 
For pharma companies and CDMOs, the critical question is what type of conjugates are driving pipeline and potentially market growth. In terms of the type of drug conjugate, ligand-mediated RNAi conjugates hold the highest share (around 55%) of the current market, a level that is projected to stay steady through 2035, when the market share of   ligand-mediated RNAi conjugates will reach about 57% (see Figure 2), according to the Roots Analysis study. Ligand-conjugated antisense medicines (i.e., antisense oligonucleotides) are projected to be the second leading XDC sector by 2035, with an approximate 20% market share, closely followed by peptide–radionuclide conjugates, which are targeted radiopharmaceuticals that link a peptide to a radioactive isotope, with a projected market share of around 18% by 2035. Small-molecule drug conjugates, virus-like drug conjugates, and other radioconjugates round out the XDC sector (see Figure 2).  

On a commercial basis, Chaudhary estimates that there are currently approximately 15-16 XDCs on the market. As for some examples, the commercial market for ligand-mediated RNAi conjugates is dominated by GalNAc (N-acetylgalactosamine) conjugates. Some high-performing drugs in this area include Novartis’ Leqvio (inclisiran), an anti-cholesterol drug with 2025 sales of $1.2 billion, and Alnylam Pharmaceuticals’ Amvuttra (vutrisiran), a drug for treating two distinct forms of transthyretin-mediated amyloidosis, a rare disease caused by the buildup of abnormal deposits of a protein called amyloid in the body, with 2025 sales of $2.3 billion.  

Other strong-performing XDCs include two oncology peptide–radionuclide conjugates from Novartis: Lutathera (lutetium ¹⁷⁷ dotatate) and Pluvicto (lutetium¹⁷⁷ vipivotide tetraxetan) (more specifically a small-molecule peptidomimetic radionuclide). Lutathera, for treating somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors, posted 2025 sales of $816 million. Pluvicto, for treating certain forms of prostate cancer, had 2025 sales of $2.5 billion.  

Looking ahead 
The future bodes favorably for XDCs, with several key issues highlighted in the Roots Analysis study. Ongoing advancements in linker stability, payload potency, and targeted delivery mechanisms are enhancing the therapeutic index of XDCs, a precision approach in oncology for treating both hematologic malignancies and solid tumors. 

The growing interest in delivering RNA-based therapeutics through XDC formats is driving innovation in oligonucleotide payload chemistry, stability, and controlled-release systems. As developers refine these payloads to enhance intracellular delivery and reduce immunogenicity, XDCs are emerging as a promising modality for precision gene regulation and targeted genetic intervention. 

In addition, next generation hybrid XDCs that combine multiple payload classes, such as small molecules, peptides, and oligonucleotides, are gaining traction due to their ability to modulate complex disease pathways, according to the Roots Analysis study. Moreover, emerging platforms now support dual-mechanism or multi-mechanism payload strategies without compromising stability, positioning XDCs as a transformative therapeutic class capable of overcoming traditional monotherapy limitations. 

ADCs remain an important market 
While XDCs rise, ADCs will continue to be an important sector in the bio/pharmaceutical industry. The current ADC market is valued at between $18 billion and $19 billion, and by 2035, it is expected to reach between $40 billion and $45 billion, representing annual growth of nearly 10%, says Chaudhary, with the North American market alone projected to reach $30 billion. Partnering and clinical trial activity in ADCs continues to be strong. Approximately 300 partnerships in ADCs are now in play, with 50% of these deals representing licensing deals, and annual growth overall in partnering deals of approximately 15% to 20%. In addition, approximately 1,500 clinical trials in ADCs have been registered since 2020. Approximately 850 ADC programs are in development, with 650 of these programs comprised of unique therapies by approximately 175 to 180 drug developers. Of these programs, 50% to 55% of all the ADC programs are in clinical development, with 40% to 45% in early-stage development, preclinical or discovery phases. “Overall, it is very strong growth, and I don’t anticipate this is going to change in the next one decade,” says Chaudhary. 

Chaudhary also points to several interesting technology trends in ADCs. “The first one is site-specific conjugation, which is actually very important. Then there is the emergence of hydrophilic linkers, and they address the challenge of hydrophobicity and aggregation,” he says. “This is becoming increasingly important as companies push towards more potent payloads. There is also the next generation of cleavable linkers, which are trying to address the problem of premature release with newer approaches making the release more precise and biologically triggered. And something which is very interesting is the concept of dual and multi-load, multi-payload ADCs, and this is probably one of the most exciting next generation things which is happening. Here, instead of having just one antibody andone payload, now the concept entails one antibody with two payloads or three payloads, and this rationale is primarily to attack the tumor through different mechanisms of action at the same time.” 

Multi-program licensing and technology-access arrangements to secure differentiated capabilities without building every ADC component internally and to reusable platforms is becoming increasingly important, according to another Roots Analysis study, The Antibody Drug Conjugate Market. For instance, in May 2026, Pfizer committed $650 million upfront, with up to $9.85 billion in milestones, under a 12-program oncology collaboration with Innovent Biologics that includes ADCs featuring differentiated payloads. In another example, in June 2026, InduPro, a clinical-stage bio/pharma company, licensed Lonza’s GlycoConnect, HydraSpace and linker-payload technologies for bispecific ADCs targeting up to two oncology antigens. “These transactions indicate investment is shifting from individual assets toward reusable platforms accelerating candidate development, distributing technical risk and creating repeatable value across multiple programs,” according to the Roots Analysis study. 

For CDMOs involved in the ADC market, the global ADC contract manufacturing market, valued at $1.72 billion in 2025, is projected to reach $2.14 billion in 2026 and $3.21 billion by 2035, representing a CAGR of 4.6% during the forecast period, according to the study, The ADC Contract Manufacturing Market, by Roots Analysis.  

The full episode of the DCAT Value Chain Insights podcast, “Beyond ADCs: Next-Generation Drug Conjugates,” may be found here.