T-DM1, the first approved ADC, are released from lysosomes and bind to microtubules to destroy the structure of microtubules and selectively kill HER2-positive malignant tumor cells, but failed to exhibit better antitumor efficacy than taxane (a class of chemotherapeutic drugs for GC) in HER2-positive GC in a phase II/III clinical trial13,27–29. This evidence concerns the gene ERBB2 and gastric cancer.