Table 2 ∣.

Bispecific antibodies approved or nearing approval by the FDA and EMA

Target	Antibody	Structure	Format	Major indications	Adverse effects
T cell engagers
CD19xCD3	Blinatumomab		Lacks Fc (short half-life ~2 h) ~54 kDa	B cell precursor ALL	CRS Neurotoxicity Infection Cytopenia TLS
CD20xCD3	Mosunetuzumab		IgG1 Fc (half-life extension) N297G mutation (aglycosylation and reduced ADCC) ~146 kDa	Lymphoma	CRS Neurotoxicity Infection Cytopenia Embryo–fetal toxicity
	Epcoritamab		IgG1 Fc (half-life extension) L234F, L235E, D265A mutation (reduced ADCC) ~146 kDa	Lymphoma	CRS Neurotoxicity Infection Cytopenia TLS
	Glofitamab		Two anti-CD20 scFvs linked with one anti-CD3 scFv IgG1 Fc (half-life extension) P329G, L234A, L235A mutation (reduced ADCC) ~194 kDa	Lymphoma	CRS Neurotoxicity Infection Cytopenia
	Imvotamab (in clinical trial)		IgM pentamer (ten CD20-binding sites) Albumin fusion (half-life extension) ~960 kDa	Lymphoma	CRS Cytopenia Hypophosphatemia
BCMAxCD3	Teclistamab		IgG4 Fc (half-life extension) S228P (hinge stabilization), and F234A and L235A mutation (reduced FcγR binding) ~143 kDa	Multiple myeloma	CRS Neurotoxicity Infection Cytopenia Hepatotoxicity Embryo–fetal toxicity
	Elranatamab		IgG2 Fc (half-life extension) ~145 kDa	Multiple myeloma	CRS Neurotoxicity Cytopenia
GPRC5DxCD3	Talquetamab		IgG4 Fc (half-life extension) S228P (hinge stabilization), and F234A and L235A mutation (reduced FcγR binding) ~147 kDa	Multiple myeloma	CRS Neurotoxicity Cytopenia Skin rash Hepatotoxicity Embryo–fetal toxicity
GP100xCD3	Tebentafusp		Lacks Fc, MW above renal filtration cut-off (half-life 6–8 h) ~75–77 kDa	Melanoma	CRS Skin rash Hepatotoxicity Embryo–fetal toxicity
Receptor blockers
EGFRxcMET	Amivantamab		IgG1 (half-life extension) Fc afucosylation (enhanced ADCC) K409R, F405L mutation (for Fab exchange) ~146 kDa	Lung cancer	Skin rash Stomatitis Muscle pain Cytopenia Electrolyte abnormality Embryo–fetal toxicity
Her2xHer2	Zanidatamab (in clinical trial)		Two anti-HER2 scFvs (bind two distinct HER2 epitopes) IgG1 (half-life extension) ~125 kDa	HER2+ cancers	Diarrhoea Infusion reaction Cardiac failure
PD1xCTLA4	Volrustomig MEDI5752 (in clinical trial)		IgG1 (half-life extension) L234F, L235E, P331S mutation (reduced FcγR binding) ~145 kDa (estimated)	Multiple solid tumours	Checkpoint inhibitor-associated irAEs: Diarrhoea Thyroid disorders Skin rash Hepatotoxicity

ADCC, antibody-dependent cellular cytotoxicity; ALL, acute lymphoblastic leukaemia; CRS, cytokine release syndrome; Ig, immunoglobulin; irAEs, immune-related adverse events; IV, intravenous; kDa, kilodalton; scFv, single-chain variable fragment; TLS, tumour lysis syndrome. Fc-bearing bispecific antibodies also carry Fc mutations that enable pairing of the heterogenous heavy chains (not shown).