CD16-EGFR bispecific VHHs induce lysis of EGFR expressing tumor cells in the presence of NK cells. Cytotoxicity exerted by healthy donor-derived NK cells after a 24-h co-culture ±100 nM bispecific VHHs ± tumor cell lines expressing different levels of EGFR: A431 (EGFR++), HCT116 (EGFR+RASmut), Colo829 (EGFR−). (A) Resting NK cells were used as effectors; (B) NK cells were pre-activated overnight with IL-2 and IL-15. Cytotoxicity was determined by assessing the relative percentage of living tumor cells compared to the tumor-alone condition. E:T ratio: 1:1. The bars represent mean ± SEM. Significance is presented as p < 0.05 *. A431 n = 6 (A,B); HCT116 n = 5 (A) and n = 4 (B); Colo829 n = 3 (A,B). p-values were determined by a two-tailed paired t-test. Abbreviations: C-7 = C21-7D12 bispecific VHH, 7-C = 7D12-C21 bispecific VHH.