Table 1. Overview of (potential) advantages of bispecific heterodimeric antibodies over classical IgG antibodies and their combination.
Area | (Potential) advantage of bispecific (heterodimeric) antibodies |
---|---|
Structure |
• Natural IgG architecture and geometry • Lower risk for immune complexes compared with multivalent bispecific antibodies due to monovalency for each target |
Targeting |
• Transport e.g., delivery over the blood-brain barrier • Effector cell recruitment to enhance killing • Selective targeting of a selected cell population characterized by two targets to improve safety and/or efficacy |
Efficacy |
• Blocking two pathways in parallel to impair resistance formation (receptor tyrosine kinases, angiogenic ligands) • Potential for synergistic effects compared with combination therapy |
Development | • No need for separate single agent trials followed by combination trials • No development of a co-formulation • No extended infusion times (convenience) • Advantageous pharmacoeconomics and lower cost of goods compared with two single antibodies • Potential for combination with additional agents |