Antibody‒cell conjugates: A novel “off-the-shelf” modality bridging ADCs and CAR-T for cancer immunotherapy

Antibody‒cell conjugates (ACCs) represent a promising therapeutic strategy emerging in the biopharmaceutical industry to overcome the limitations of current immunotherapies. ACCs constitute a novel class of living drugs developed by anchoring functional antibodies onto the surface of living cells via specific linkers or conjugation methods. These carrier cells encompass both immune effector cells (such as Natural Killer cells, γδ T cells, and activated T cells) and non-immune cells (such as erythrocytes and platelets). Distinct from genetic engineering, ACCs directly modify the cell surface using chemical biology, enzymatic catalysis, or physical assembly, thereby endowing cells with precise tumor-targeting capabilities while preserving their intrinsic biological functions. This technology facilitates the scalable production of “off-the-shelf” therapeutics and has shown promising potential in treating both hematological malignancies and refractory solid tumors with a superior safety profile. This review systematically examines the current construction strategies and carrier cell selection for ACCs, covering both immune effector cells and non-immune carrier cells, and discusses the clinical progress, key challenges, and future directions.