PD-(L)1/VEGF双抗走向“百家争鸣”

Core Viewpoint - The article discusses the emergence of bispecific antibodies targeting both PD-(L)1 and VEGF in cancer treatment, highlighting the approval of Ivoris monoclonal antibody as the first of its kind in China, which has sparked a wave of interest and competition in this field [2][3]. Group 1: Overview of Bispecific Antibodies - The combination of immune therapy and anti-angiogenesis drugs has shown significant clinical success, but traditional dual-drug regimens face challenges such as dosage control and side effects [2]. - Ivoris monoclonal antibody, developed by Kangfang Biopharma, is the first PD-1/VEGF bispecific antibody approved globally, marking a significant milestone in the industry [2][3]. Group 2: Competitive Landscape - Over 17 PD-(L)1/VEGF bispecific antibodies are currently in clinical trials globally, indicating a highly competitive environment with numerous companies entering the market [3]. - The competition is characterized by a diverse range of technical approaches and designs, leading to a "hundred flowers bloom" scenario in the industry [3][4]. Group 3: Key Technical Variables - Three critical variables differentiate the designs of PD-(L)1/VEGF bispecific antibodies: 1. Selection of immune targets (PD-1 vs. PD-L1), which affects the breadth of immune response and potential side effects [6]. 2. Choice of anti-angiogenesis targets (VEGF vs. VEGFR), influencing the mechanism of action and potential adverse effects [6]. 3. Antibody structure and fusion methods, which impact the drug's pharmacological properties and production processes [9]. Group 4: Representative Technical Designs - Kangfang Biopharma's Ivoris features a symmetrical tetravalent structure ("2+2 design") that enhances affinity for both PD-1 and VEGF targets, showcasing a promising design in the bispecific antibody landscape [13]. - Other companies are exploring different fusion strategies, such as C-terminal and N-terminal fusions with nanobodies, which may offer advantages in tissue penetration and efficacy [14]. Group 5: Clinical Relevance - The article emphasizes that despite theoretical advantages of various designs, the true measure of success will be clinical efficacy and safety data, as past experiences with PD-1 and PD-L1 antibodies have shown that theoretical differences do not always translate into clinical outcomes [16][17]. - The focus should remain on actual clinical results, production efficiency, and market competitiveness rather than solely on innovative structural designs [20].