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Co-phagocytosis of VEGFA with HER2-overexpressing cancer cells induced by HER2-VEGFA–bispecific antibodies improves antitumor responses
Yang Lu, … , Songbo Qiu, Zhen Fan
Yang Lu, … , Songbo Qiu, Zhen Fan
Published September 4, 2025
Citation Information: JCI Insight. 2025;10(20):e194494. https://doi.org/10.1172/jci.insight.194494.
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Research Article Clinical Research Immunology Oncology

Co-phagocytosis of VEGFA with HER2-overexpressing cancer cells induced by HER2-VEGFA–bispecific antibodies improves antitumor responses

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Abstract

We conceived of a type of antitumor mechanism of action by which a soluble target in the tumor microenvironment, such as a tumor-driving growth factor, can be phagocytized along with cancer cells via antibody-dependent cellular phagocytosis (ADCP) using an antibody bispecific for the soluble target and a solid target overexpressed on the cancer cell surface. We explored this concept through engineering bispecific antibodies (BsAbs) co-targeting human epidermal growth factor receptor-2 (HER2) and vascular endothelial growth factor A (VEGFA) in an scFv-IgG format (VHS). We showed that the HER2-VEGFA BsAbs but not the parental antibodies alone or in combination induced co-phagocytosis of VEGFA and HER2-overexpressing cancer cells by tumor-associated macrophages via ADCP. In both immunocompromised and immunocompetent mice with aggressive tumors, the BsAbs demonstrated greater anti-metastasis activity and produced a greater survival benefit than the parental antibodies alone or in combination, in a manner dependent on Fcγ receptors on the macrophages. Our results provide proof of the concept that HER2-VEGFA BsAbs achieve enhanced antitumor activity by leveraging HER2 overexpressed on the cancer cell surface to induce co-phagocytosis of VEGFA. Our findings warrant clinical testing of the strategy to treat metastasis and recurrence of HER2-overexpressing solid tumors that respond to anti-VEGFA therapy.

Authors

Yang Lu, Songbo Qiu, Zhen Fan

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Figure 1

Physicochemical properties and functional characterization of TB-VHS.

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Physicochemical properties and functional characterization of TB-VHS.
(A...
(A) Schematic illustration of the BsAb in the VHS platform. The blue asterisks represent VEGFA to which the BsAb can bind, and the red asterisks represent HER2 to which the BsAb can bind. (B) Coomassie blue–stained gels of TB-VHS and its parental antibodies separated by SDS-PAGE under reducing (right) and nonreducing (left) conditions. HC, heavy chain; LC, light chain; MW, molecular weight. (C) Specific binding of TB-VHS and its parental antibodies to HER2 and human VEGFA detected by ELISA. For detecting HER2 binding, HER2 ECD recombinant protein–coated 96-well microplates were used to capture the antibodies, and antibodies were detected by HRP-labeled anti–human IgG antibody. For detecting VEGFA binding, rabbit anti–human Fc antibody–coated 96-well microplates were used to capture the antibodies, and antibodies were incubated with biotinylated human VEGFA and detected by streptavidin-HRP conjugate. (D) Thermal stability of TB-VHS. TB-VHS, bevacizumab, and trastuzumab were incubated in a water bath at 50°C for 1 hour, and then binding of these antibodies and antibodies stored at 4°C against HER2 and human VEGFA was detected by ELISA as in C. (E) Competitive binding of TB-VHS to HER2 and human VEGFA. TB-VHS (5 nM) was incubated with either 5 nM biotinylated VEGFA and increasing concentrations of HER2 ECD recombinant protein (left) or 5 nM HER2 ECD recombinant protein and increasing concentrations of VEGFA (biotinylated and unlabeled) (right) in a solution at 4°C for 1 hour. Then, separate 96-well microplates coated with rabbit anti–human Fc antibody were used to capture TB-VHS. Binding of VEGFA to TB-VHS was detected by streptavidin-HRP, and binding of HER2 ECD to TB-VHS was detected by a biotinylated anti-HER2 antibody and then streptavidin-HRP.

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