Notably, DM4 undergoes metabolic transformation (S-methylation) to yield S-methyl-DM4, a metabolitethat demonstrates notable cytotoxicity as its parental drug., In addition to its direct cytotoxic effect, the ADC’s efficacyis further amplified by the “bystander effect”., This phenomenon allows the released DM4 and S-methyl-DM4to diffuse into adjacent tumor cells and cancer-associated cells (suchas cancer-associated fibroblasts, immune cells, and adipocytes) thatmay lack or express low levels of LGALS3BP, thereby broadening theantitumor response. This evidence concerns the gene LGALS3BP and cancer.