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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 6

Improvement of tumor-free survival of hmHER2Tg mice with D5-HER2 tumors by TG-VHS compared with combination of anti-VEGFA and anti-HER2 antibodies.

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Improvement of tumor-free survival of hmHER2Tg mice with D5-HER2 tumors ...
(A) Tumor growth in individual mice in each treatment group. D5-HER2 syngeneic tumor cells (2.5 × 105 cells/mouse) were implanted subcutaneously into hmHER2Tg mice. The next day (day 1), the mice were randomly divided into 5 groups, and treatment was initiated. Mice received a control mouse IgG (mIgG) (100 μg/mouse), G6.31.2a anti-VEGFA antibody (100 μg/mouse), 4D5.2a anti-HER2 antibody (100 μg/mouse), G6.31.2a plus 4D5.2a (100 μg/mouse + 100 μg/mouse), or TG-VHS (150 μg/mouse, equivalent to 100 μg in molar mass of conventional antibody) intraperitoneally twice per week for 6 weeks. Tumor measurement was stopped after day 23, when mice started to die or had to be euthanized owing to moribund status. (B) Survival curves of the mouse treatment groups described in A. Treatments were stopped after 6 weeks, and the mice were monitored for survival up to 257 days. (C) Tumor challenge and rechallenge in hmHER2Tg mice. Age-matched treatment-naive hmHER2Tg mice were challenged, and the mice in A and B that remained tumor-free during the extended period (257 days) were rechallenged with equal amounts (2.5 × 105 cells/mouse) of the same parental D5 tumor cells (without HER2 overexpression). Tumor growth was measured twice per week for 2 weeks. Plots show tumor volume in individual mice on day 14. (D) Immunophenotypic analysis of the spleen specimens from the mice in each group in C. Single-cell suspensions were prepared for flow cytometry analysis for the relevant markers shown. *P < 0.05; **P < 0.01; ***P < 0.001; ****P < 0.0001 by unpaired t test (A), log-rank test (B), or 1-way ANOVA with Dunnett’s multiple-comparison test (C and D). Rx, treatment; NS, not significant.

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