2,045 ADC programs. 23 approved. ~440 in the clinic. 393 deals since 2021. This is the full ADC landscape mapped from preclinical through approved, updated for Q3 2026.

The report covers the data first. The pipeline universe by phase, with China now originating half of all programs. Target crowding across 313 targets, where HER2, EGFR, TROP2, B7-H3, c-Met, and HER3 each carry 20+ clinical programs. The two payload families that account for 44% of clinical-stage assets. Dealmaking at record pace, with 93 deals in 2025 and 2026 on a run-rate near 70, while disclosed upfronts remain a thin slice of headline value.

Then Sleuth's read on what the data means. The therapeutic window as the binding constraint on ADC combination strategy. China's structural advantage in medicinal chemistry driving half the global pipeline and a standing sourcing channel of 150+ mapped deals. Dual-payload as the next inflection, collapsing combination therapies into a single molecule. The near-term catalyst calendar dominated by incumbents. Why first-line conversion, not approval, is the real value trigger. B7-H3's closing entry window. Non-oncology ADCs as a payload-innovation story rather than a target-selection story.

Five predictions close the report, including a call on the first dual-payload platform deal exceeding $1B and non-oncology becoming the next pre-proof platform bet.