This article is the second half of the Morningglorysciences Summer Beginner Series Grand Summary. In Part 1, we reviewed anti-obesity drugs, ADCs, and In vivo CAR-T cell therapy, comparing their strengths and shared challenges. Here in Part 2, we add bispecific antibodies (BsAbs) to the picture, completing a panoramic view of today’s most important therapeutic modalities.
The aim of this installment is to move beyond understanding individual technologies to ask: How do these modalities compete, complement, and converge to shape the therapies of tomorrow? By doing so, readers step beyond “beginner” knowledge into a truly strategic perspective on modern medicine.
Introduction｜The Role of Part 2
In previous installments, we examined the history, technology, clinical performance, and market trends of each modality. Yet in the real world of research and healthcare, modalities do not exist in isolation. They evolve through competition, collaboration, and mutual learning.
Bispecific antibodies exemplify this dynamic. As a culmination of antibody engineering, they overlap with ADCs and CAR-T while opening entirely new avenues. Understanding BsAbs allows us to complete the “map” of current drug innovation.
Chapter 1｜What Are Bispecific Antibodies?
Bispecific antibodies are engineered to bind to two different antigens simultaneously, enabling functions that conventional monoclonal antibodies cannot achieve.
- Linking tumor cells with T cells (e.g., CD3 × CD19)
- Targeting two tumor antigens at once (e.g., HER2 × HER3)
- Simultaneously blocking and activating immune pathways
In this sense, BsAbs act as “bridges.” Multiple platforms (BiTE, DART, CrossMab, etc.) have been developed, each reflecting unique engineering strategies from different companies and institutions.
Chapter 2｜Approved Drugs and Development Trends
The first landmark came with Amgen’s blinatumomab (Blincyto). Approved by the FDA in 2014 for CD19-positive B-cell leukemia, it was the first BiTE (bispecific T-cell engager) to link T cells directly with tumor cells.
Subsequent breakthroughs include teclistamab and mosunetuzumab in CD20-positive lymphomas. In solid tumors, formats such as HER2 × HER3 and EGFR × MET are being tested, addressing tumor heterogeneity with novel flexibility.
Today, more than 200 BsAbs are in clinical development, most in immuno-oncology but with growing applications in ophthalmology, inflammation, and infectious disease. They stand at the forefront of “the next antibody era.”
Chapter 3｜Comparisons and Complementarity with Other Modalities
BsAbs compete with and complement other modalities in distinct ways:
- With anti-obesity drugs: Minimal direct overlap, but research explores applications in chronic disease beyond oncology.
- With ADCs: Combining BsAbs with ADCs could enhance selectivity, enabling “next-generation targeted delivery.”
- With CAR-T: BsAbs offer an “off-the-shelf” immune engager, potentially serving as alternatives or bridge therapies to CAR-T.
CAR-T and BsAbs both mobilize T cells against tumors. But while CAR-T requires personalized, costly manufacturing, BsAbs can be produced and administered more readily. The future will likely see a division of labor and complementarity between the two.
Chapter 4｜Cross-Cutting Technological Evolution
Viewed across all four modalities—anti-obesity drugs, ADCs, CAR-T, and BsAbs—common technological trends emerge:
- Target design: GLP-1 receptors, HER2/TROP2, CD19/CD20—ever more precise targeting
- Delivery: Oral formulations, linker chemistry, lipid nanoparticles (LNPs), antibody format optimization
- Immune modulation: Balancing safety with efficacy through fine-tuned immune control
These advances are not isolated—they cross-pollinate. Long-term safety frameworks in metabolic drugs inform immunotherapy trials. Antibody engineering in ADCs and BsAbs informs CAR-T enhancements. The ecosystem evolves collectively.
Chapter 5｜Impact on Healthcare Economics and Industry Structure
The rise of new modalities is reshaping not just therapeutics, but entire systems of healthcare and industry.
- High cost: Annual treatment costs in the hundreds of thousands of dollars strain insurance systems.
- Competition: Giants such as Daiichi Sankyo, Roche, and Amgen compete and collaborate with biotech startups.
- Healthcare systems: Rapid approval frameworks and HTA (health technology assessment) redefine pricing dynamics.
In the coming decade, modalities will be seen not just as “collections of technologies,” but as forces reshaping industry and healthcare economics.
Chapter 6｜The Next 10 Years — Toward Convergence
The future points to convergence:
- AI-driven drug design: Accelerating target discovery and molecule design
- Personalized medicine: Tailoring therapy to genetic and immune profiles
- Digital integration: Using digital twins and remote monitoring to maximize therapeutic outcomes
Clinical trials are already adopting AI-based target prediction and real-world data analysis. These innovations span modalities, heralding a new era where the very process of “drug development” transforms.
Conclusion｜From Beginner to the Frontline
Anti-obesity drugs, ADCs, In vivo CAR-T, and bispecific antibodies together form a landscape that spans pharmacology, antibody engineering, cell therapy, and immune modulation.
With this Grand Summary Part 2, the Summer Beginner Series moves beyond “introductory” and becomes an entry point into frontline research and industry trends.
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This article was edited by the Morningglorysciences team.
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