{"entity":{"id":"bispecific-antibody","kind":"technology","name":"Bispecific antibodies","aka":[],"tldr":"A bispecific antibody is one antibody with two different grabbing arms, so it can block two targets at once or pull an immune cell onto a cancer cell.","summary":"Two families: T-cell engagers (CD3 arm; see separate entry) and dual-target blockers such as amivantamab (EGFR×MET), zanidatamab (HER2 biparatopic), zenocutuzumab (HER2×HER3 for NRG1 fusions), and ivonescimab (PD-1×VEGF), which beat pembrolizumab head-to-head on PFS in NSCLC (HARMONi-2). Bispecifics are also the antibody chassis for the next ADC generation.","status":"approved","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/Bispecific_monoclonal_antibody","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Bispecific_monoclonal_antibody"}],"tags":[],"related":["trispecific-antibodies"],"cancers":["dlbcl","follicular-lymphoma","non-hodgkin-lymphoma"],"sections":["targeted-therapy","immunotherapy"],"technologies":["t-cell-engager","bispecific-adc"],"targets":["cd3","cd20"],"drugs":["amivantamab","zanidatamab","zenocutuzumab","ivonescimab"],"companies":["xencor","amunix-pharmaceuticals","bicara-therapeutics","compass-therapeutics","cullinan-therapeutics","igm-biosciences","janux-therapeutics","marengo-therapeutics","xilio-therapeutics","ranata-therapeutics","harbour-biomed"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":["monoclonal-antibody-manufacturing"],"notes":["Lymphoma: the CD20 by CD3 bispecifics are the clearest working example of the format. CD3 is not a tumour antigen at all; it is the handle the antibody uses to grip a T cell so that the other arm can hold the tumour, which bypasses the loss of antigen presentation that defeats a checkpoint inhibitor. The price is built into the mechanism: cytokine release syndrome and neurotoxicity are the synapse working, which is why step-up dosing exists."],"principle":"Engineered heavy/light chain pairing (knobs-into-holes, CrossMab, DuoBody) yields one molecule with two specificities.","strengths":["Combination therapy in one molecule","Avidity for co-expressing tumour cells"],"limitations":["Manufacturing complexity","Dose finding for two arms"],"since":2014},"route":"/technologies/bispecific-antibody/","neighbours":{"technology":[{"id":"monoclonal-antibody-manufacturing","kind":"technology","name":"Antibody manufacturing (CHO bioprocessing)","route":"/technologies/monoclonal-antibody-manufacturing/"},{"id":"bispecific-adc","kind":"technology","name":"Bispecific ADC","route":"/technologies/bispecific-adc/"},{"id":"downstream-purification-chromatography","kind":"technology","name":"Downstream purification (Protein A capture, viral clearance, 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