Antibodies are the most rapidly growing drug class and have a major impact on human health, particularly in oncology, autoimmunity and chronic inflammatory diseases. Many of the best understood and most tractable cell surface and secreted targets with known roles in human diseases have been extensively exploited for antibody drug development. In this Review, we focus on emerging and novel mechanisms of action of antibodies and innovative targeting strategies that could extend their therapeutic applications, including antibody–drug conjugates, bispecific antibodies and antibody engineering to facilitate more effective delivery. These strategies could enable the pursuit of difficult to hit, less well-understood or previously undruggable targets — the 'high-hanging fruit'.

抗体是增长最快的药物类别，对人类健康，尤其是肿瘤学，自身免疫性和慢性炎症性疾病具有重大影响。在人类疾病中具有已知作用的许多最了解，最易处理的细胞表面和分泌靶标已被广泛用于抗体药物的开发。在本综述中，我们重点介绍抗体的新兴作用机制和创新的靶向策略，这些策略可以扩展其治疗应用，包括抗体-药物偶联物，双特异性抗体和抗体工程技术，以促进更有效的递送。这些策略可以使人们实现难以实现的，目标较少的理解或以前难以捉摸的目标，即“悬而未决的果实”。