Targeted oncology · London
Antibody-drug conjugate (ADC) infusion - private in London.
A day-case infusion of Enhertu, Trodelvy, Padcev, Elahere or Blenrep - given by a consultant medical oncologist in a CQC-registered day unit, with 24/7 chemotherapy on-call, ophthalmology on-site for the ocular ADCs, and MDT sign-off before the first cycle.
Why patients choose us
- 01
A named medical oncologist, biomarker-first
Not a general chemo chair. A consultant medical oncologist who selects the right ADC by antigen, IHC score, prior lines and toxicity profile.
- 02
The right ADC for the tumour
HER2, Trop-2, Nectin-4, FRα, BCMA, CD30, CD22, CD79b - the antigen decides the drug. We only recommend an ADC when the biomarker fits.
- 03
Independent, and free
We are paid by no clinic or pharma company, so the recommendation is impartial and costs you nothing.
What ADCs are
A monoclonal antibody, a cleavable linker, a cytotoxic payload.
An antibody-drug conjugate is a targeted delivery system. The antibody finds a tumour antigen, the tumour cell internalises it, and the payload is released inside the cancer cell.
The antibody
A monoclonal antibody that binds a surface antigen preferentially expressed on tumour cells - HER2, Trop-2, Nectin-4, FRα, BCMA, CD30, CD22, CD79b or CD19.
The linker
A cleavable chemical bridge that keeps the toxic payload attached in the bloodstream and releases it only after the ADC is internalised by the tumour cell.
The payload
A highly potent cytotoxic - topoisomerase I inhibitor, MMAE, MMAF, DM1 or DM4 - too toxic to give as free chemotherapy, delivered in a concentrated dose inside the tumour cell.
The result is selective, high-dose chemotherapy delivered where it matters, sparing much of the systemic toxicity that comes with a conventional intravenous cytotoxic. A "bystander effect" from cleaved payload gives some ADCs (notably Enhertu) activity against tumour cells with lower antigen expression, which is why HER2-low breast cancer now has a licensed ADC option.
Indicative pricing
What a private ADC infusion costs in London.
Indicative ranges per cycle across our partner units. Total course cost depends on how long you stay on treatment before progression - typically £45,000 to £220,000.
In short
A licensed ADC in our London network: £5,500 to £11,000 per cycle, home the same day.
| ADC | Indicative cost | Infusion time | Schedule |
|---|---|---|---|
| Enhertu (trastuzumab deruxtecan) - per cycle | £8,500 to £11,000 | 90 min IV | Every 21 days |
| Trodelvy (sacituzumab govitecan) - per cycle | £6,500 to £9,000 | 60 min IV | Days 1 and 8 of 21 |
| Padcev (enfortumab vedotin) - per cycle | £7,500 to £10,500 | 30 min IV | Days 1, 8, 15 of 28 |
| Kadcyla (T-DM1) - per cycle | £5,500 to £8,000 | 30 to 90 min IV | Every 21 days |
| Elahere (mirvetuximab soravtansine) - per cycle | £7,000 to £9,500 | 60 min IV | Every 21 days |
| Typical full course (to progression) | £45,000 to £220,000 | Varies | Months to years |
Prices vary by drug list price, by unit, by pre-medications and by whether supportive drugs (G-CSF, prophylactic eye drops, IV hydration) are included in the cycle price. We come back with a firm quote across two or three centres within one working day.
The journey
From referral to restaging - what happens, in order.
One consultant medical oncologist and one chemotherapy nurse team from first message to restaging - including baseline echocardiograms, ophthalmology and MDT sign-off.
Phase 1 · Before your first cycle
Concierge, off-stage for you
Phase 2 · On the day
Half a day at the unit
Phase 3 · After
Every 3 to 4 weeks
- 01
Before
You send us the histology and prior treatment
A short, confidential form. Diagnosis, IHC and FISH results, prior lines of therapy, current scans and any recent bloods.
- 02
Before
We come back with a recommendation
Within one working day: whether an ADC fits, which molecule, and how it sits against immunotherapy or a clinical trial. Indicative cost per cycle.
- 03
Before
We arrange baseline work-up
Usually within one to two weeks. Baseline echocardiogram or MUGA for HER2 agents, HbA1c for Padcev, ophthalmology baseline for Blenrep, Elahere or Tivdak.
- 04
On the day
Arrival at the day unit
Bloods, pre-medications (antihistamine, paracetamol, dexamethasone) and observations. Line placement or port access by the chemotherapy nurse.
- 05
On the day
The infusion itself
30 to 90 minutes IV. First cycle is given more slowly with close monitoring for infusion reactions; subsequent cycles are quicker if the first is tolerated.
- 06
On the day
Home the same day
A short observation window after the infusion, written aftercare, and home the same afternoon. Anti-emetics and a symptom diary provided.
- 07
After
Restaging and toxicity review
Bloods before every cycle. CT restaging every 8 to 12 weeks. Ophthalmology reviews for Blenrep, Elahere or Tivdak. Treatment continues until progression or unacceptable toxicity.
Typical time to first cycle: 1 to 2 weeks. Cycle interval: 3 to 4 weeks. Restaging: every 8 to 12 weeks.
Cancer types with ADC options
Where ADCs fit today - and where they are moving.
Breast (HER2-positive, HER2-low, TNBC, HR-positive), urothelial, ovarian, gastric, lung (EGFR, HER2), cervical, myeloma and B-cell, T-cell and Hodgkin lymphoma, plus ALL.
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HER2-positive or HER2-low breast cancer
Enhertu is standard second-line for HER2-positive metastatic breast cancer and now first-line for many HER2-low cases (IHC 1+ or 2+/FISH-negative).
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Triple-negative or HR-positive breast cancer
Trodelvy in Trop-2 expressing metastatic TNBC after one prior line, and in endocrine-pretreated HR-positive HER2-negative breast cancer.
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Urothelial (bladder) cancer
Padcev with pembrolizumab is now first-line in metastatic urothelial cancer, replacing platinum-based chemotherapy for many patients.
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FRα-positive ovarian cancer
Elahere in platinum-resistant ovarian cancer with folate receptor alpha expression (75% or more tumour cells on IHC).
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HER2-mutated or EGFR-MET lung cancer
Enhertu in HER2-mutated non-small cell lung cancer; Rybrevant in EGFR exon 20 insertion or MET-amplified NSCLC after prior TKI.
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CD30-positive lymphoma
Adcetris (brentuximab vedotin) in classical Hodgkin lymphoma and CD30-positive T-cell lymphomas, front-line and relapsed.
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Relapsed multiple myeloma
Blenrep (belantamab mafodotin) in triple-class refractory myeloma - back in UK use in 2025 after fresh trial data.
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Red flag: rapidly rising markers, new symptoms
Rapid clinical deterioration, cord compression symptoms or new brain symptoms need urgent oncology review before any ADC is planned.
Licensed ADCs, UK 2025
The ADC toolbox, drug by drug.
Enhertu, Kadcyla, Trodelvy, Padcev, Elahere, Blenrep, Adcetris, Besponsa, Polivy, Rybrevant, Zynlonta and Tivdak - twelve licensed molecules, twelve different indications.
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Enhertu (trastuzumab deruxtecan)
HER2-targeted antibody with a topoisomerase I inhibitor payload. Every 21 days IV. Bystander effect gives activity in HER2-low disease as well as HER2-positive.
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Trodelvy (sacituzumab govitecan)
Trop-2 antibody with SN-38 (active irinotecan metabolite). Days 1 and 8 of a 21-day cycle. Neutropenia and diarrhoea are the dose-limiting toxicities.
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Padcev (enfortumab vedotin)
Nectin-4 antibody with an MMAE payload. Days 1, 8 and 15 of a 28-day cycle. Skin reactions, neuropathy and hyperglycaemia need active monitoring.
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Kadcyla (T-DM1)
HER2 antibody with a maytansine payload. First-generation ADC, well-tolerated, used in HER2-positive breast cancer including the adjuvant setting after residual disease.
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Elahere (mirvetuximab soravtansine)
FRα antibody with DM4 payload. Every 21 days in platinum-resistant ovarian cancer with high FRα expression. Ophthalmology baseline and prophylactic eye drops required.
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Adcetris (brentuximab vedotin)
CD30 antibody with MMAE payload. Every 21 days, in combination with AVD for Hodgkin lymphoma or with cyclophosphamide-based regimens for CD30-positive T-cell lymphoma.
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Blenrep (belantamab mafodotin)
BCMA antibody with MMAF payload. Every 3 weeks in relapsed myeloma. Ocular keratopathy is the signature toxicity; ophthalmology on every cycle.
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Second-opinion review
A specialist review of your histology, biomarkers and prior treatment - sometimes the answer is a clinical trial, an immunotherapy switch or a bispecific rather than an ADC.
Also in UK use: Besponsa (inotuzumab ozogamicin) for CD22-positive ALL, Polivy (polatuzumab vedotin) for CD79b DLBCL, Rybrevant (amivantamab) for EGFR-MET lung cancer, Zynlonta (loncastuximab tesirine) for CD19-positive DLBCL, and Tivdak (tisotumab vedotin) for cervical cancer.
Where ADC infusions are given
A small panel of London oncology units, we picked them.
Bupa Cromwell Oncology, Royal Marsden Private, UCLH Private, HCA London Bridge, HCA The Wellington, The Christie Private and Guy's and St Thomas' Private - full ADC formularies, ophthalmology on site and 24/7 chemotherapy on-call.
Selection criteria
How we choose every oncology day unit in our network.
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Consultant medical oncologists with ADC prescribing experience across breast, urothelial, gynaecological and haematological cancers
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CQC-registered day units with 24/7 oncology on-call and same-day admission pathways for febrile neutropenia
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On-site ophthalmology for Blenrep, Elahere and Tivdak monitoring, and cardiology for HER2-agent LVEF surveillance
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MDT review before every ADC start and access to phase I/II trial units when standard options are exhausted
Toxicity, drug by drug
The toxicity of each ADC - honestly.
Each ADC has a signature toxicity: pneumonitis for Enhertu, neutropenia and diarrhoea for Trodelvy, skin and neuropathy for Padcev, ocular keratopathy for Blenrep. All are manageable with the right monitoring.
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Enhertu: interstitial lung disease
Pneumonitis or ILD in 10 to 15% of patients, occasionally fatal. Baseline and every-cycle assessment of breathlessness, cough and oxygen saturations, with low threshold for CT.
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Trodelvy: neutropenia and diarrhoea
Grade 3 or 4 neutropenia in around 50%. Prophylactic G-CSF from cycle 1 in most patients. Loperamide and a proactive antidiarrhoeal plan are essential.
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Padcev: skin, neuropathy, hyperglycaemia
Skin rashes ranging from mild to severe Stevens-Johnson type reactions - dermatology involvement early. Peripheral neuropathy and hyperglycaemia (even in non-diabetics) monitored each cycle.
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Blenrep: ocular keratopathy
Keratopathy in around 70% of patients. Ophthalmology assessment before every cycle. Dose delays and reductions are frequent and expected.
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Elahere and Tivdak: ocular events
Blurred vision, keratitis and dry eye. Prophylactic lubricating and steroid drops from cycle 1. Regular ophthalmology reviews built into the schedule.
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Infusion reactions
Most likely at cycle 1. Pre-medication with antihistamine, paracetamol and dexamethasone. First infusion is slower with close monitoring for hypotension, rigors or bronchospasm.
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Cardiac monitoring for HER2 agents
Baseline echocardiogram or MUGA for Enhertu and Kadcyla, then every 3 months. Any drop in LVEF triggers a treatment pause and cardio-oncology review.
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Fertility, contraception and pregnancy
ADCs are teratogenic. Effective contraception during treatment and for at least 6 months afterwards. Fertility referral before starting where relevant.
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Red flags after infusion
Fever over 38 degrees, new breathlessness, chest pain, rash, severe diarrhoea, sudden vision change - call the 24/7 chemotherapy line or attend A&E the same day.
Selection biomarkers
The tests we need before we prescribe.
The antigen decides the drug. We match your biomarker profile to the ADC before we quote or book anything.
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HER2 IHC 3+ or FISH-amplified
The classic HER2-positive breast cancer profile - Enhertu is preferred second line, Kadcyla is an option in the adjuvant residual-disease setting after neoadjuvant therapy.
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HER2-low: IHC 1+ or 2+ / FISH-negative
The newer HER2-low group, now with Enhertu licensed in metastatic breast cancer after prior endocrine or chemotherapy - drives a re-biopsy in many patients previously called HER2-negative.
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Trop-2 (Trodelvy)
Trop-2 IHC is not currently required for Trodelvy in metastatic TNBC or HR-positive HER2-negative breast cancer - the licence is based on clinical trial populations rather than a companion diagnostic.
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Nectin-4 (Padcev)
Nectin-4 IHC is not required for Padcev in urothelial cancer - Nectin-4 is uniformly expressed across urothelial tumours.
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FRα for Elahere
Folate receptor alpha IHC on 75% or more tumour cells is required for Elahere in platinum-resistant ovarian cancer - a companion diagnostic test.
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CD30, CD22, CD79b, CD19, BCMA
For the haematology ADCs (Adcetris, Besponsa, Polivy, Zynlonta, Blenrep) the antigen is verified on the diagnostic biopsy - most are constitutively expressed on the target cell type.
Reading your oncology notes
Your ADC treatment plan in four parts. Read the last one first.
Whichever ADC you are on, the clinic letter your medical oncologist sends keeps to the same shape.
A quiet reminder
Oncology language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the plan before your review, just ask.
- 01 Header
Diagnosis, stage and biomarker profile
Primary site, histology, stage, HER2 IHC and FISH, Trop-2, Nectin-4, FRα, BCMA, PD-L1 and any actionable mutations relevant to ADC selection.
- 02 Regimen
Drug, dose, schedule and cycle count
Which ADC, mg/kg dose, cycle length and how many cycles are planned before restaging - together with any pre-medications and prophylactic drugs.
- 03 Findings
Response, toxicity and dose modifications
Tumour marker trend, radiological response, any grade 2 or higher toxicity and the dose reductions, delays or supportive drugs that resulted.
- 04 Impression
Continue, switch or stop
Read this first: whether the ADC continues at full dose, continues with a dose reduction, or is stopped in favour of a new line of treatment.
Recognised by major UK insurers
Cover for licensed ADCs varies by insurer and by indication - usually funded when medically indicated. We confirm cover before booking cycle 1.
Frequently asked
Everything we get asked about ADCs.
Quick answers on outpatient care, insurance, MDT sign-off, infusion time, combinations and side effects.
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Are ADC infusions outpatient?
Yes. Almost all ADC infusions are given in a day unit and you go home the same afternoon. Overnight admission is only needed if there is a significant infusion reaction, a new complication or a fever needing IV antibiotics. The first cycle is often slower to allow close observation.
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Do UK insurers cover antibody-drug conjugates?
Most major insurers (Bupa, AXA Health, Vitality, Aviva, WPA, Cigna, Healix) fund licensed ADCs for their licensed indications, subject to policy limits and prior authorisation. Cover for off-label or trial use is case-by-case. We confirm cover in writing before the first cycle.
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Will my case go through an MDT?
Yes. Every ADC start goes through a specialist tumour-site MDT with medical oncology, pathology, radiology and (where relevant) surgery, so the biomarker, prior lines and radiology are all agreed before you sit in the chair. You get the MDT summary in writing.
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How long does an ADC infusion take?
Between 30 and 90 minutes for most ADCs, plus 30 to 60 minutes of pre-medication and observation. Enhertu is usually 90 minutes at cycle 1 and 30 minutes for subsequent cycles if the first is tolerated. Padcev is 30 minutes throughout.
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Can ADCs be combined with immunotherapy or given in sequence?
Yes. Padcev is licensed with pembrolizumab as first-line urothelial treatment. Enhertu is often given after or before immune checkpoint inhibitors in appropriate cancers. Sequencing with bispecifics, CAR-T or TIL therapy is planned by the MDT on a case-by-case basis.
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Are the side effects manageable?
Most ADC side effects are predictable and manageable with dose reductions, delays and supportive care - anti-emetics, G-CSF, loperamide, prophylactic eye drops, dermatology input. The important exceptions are Enhertu-related pneumonitis and Blenrep-related keratopathy, which need active monitoring on every cycle.
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Send Enquiry
Tell us the diagnosis and we come back within a working day.
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Ready to start?
Send us your histology and we come back within a working day.
A named medical oncologist, a biomarker-first recommendation across the twelve licensed ADCs, and a quote across two or three London day units - independent, and free.