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Traditional drug safety assessment often fails to predict complications in humans, especially when the drug targets the immune system. Here, we show the unprecedented capability of two human Organs-on-Chips to evaluate the safety profile of T-cell bispecific antibodies (TCBs) targeting tumor antigens. Although promising for cancer immunotherapy, TCBs are associated with an on-target, off-tumor risk due to low levels of expression of tumor antigens in healthy tissues. We leveraged in vivo target expression and toxicity data of TCBs targeting folate receptor 1 (FOLR1) or carcinoembryonic antigen (CEA) to design and validate human immunocompetent Organs-on-Chips safety platforms. We discovered that the Lung-Chip and Intestine-Chip could reproduce and predict target-dependent TCB safety liabilities, based on sensitivity to key determinants thereof, such as target expression and antibody affinity. These novel tools broaden the research options available for mechanistic understandings of engineered therapeutic antibodies and assessing safety in tissues susceptible to adverse events., Competing Interests: SK Is a current employee of and hold equity interests or options to obtain equity interests in (Emulate Inc). Is an inventor on a patent application (P16451EP00/16/912,391) submitted by Hoffmann-LaRoche and Emulate that covers 'Method for Assessing a Compound Interacting with a Target on Epithelial Cells', CB, HG, KK Is a former employee of and hold equity interests or options to obtain equity interests in (Emulate Inc). Is an inventor on a patent application (P16451EP00/16/912,391) submitted by Hoffmann-LaRoche and Emulate that covers 'Method for Assessing a Compound Interacting with a Target on Epithelial Cells', DP Is a former employee of and hold equity interests or options to obtain equity interests in (Emulate Inc). Is an inventor on a patent application (P16451EP00/16/912,391) submitted by Hoffmann-LaRoche and Emulate that covers Method for Assessing a Compound Interacting with a Target on Epithelial Cells,, MK Is a current or former employee of and hold equity interests or options to obtain equity interests in (Emulate Inc). RB Is a former employee of and hold equity interests or options to obtain equity interests in (Emulate Inc). Is an inventor on a patent application (P16451EP00/16/912,391) submitted by Hoffmann-LaRoche and Emulate that covers, Method for Assessing a Compound Interacting with a Target on Epithelial Cells', JS, TW, TF, AF, JE, MG, AS, AG, TS, CK, MB Employment, patents and ownership of stock with Roche. CH, VM, RG, MB, EB Employment and ownership of stock with Roche. PN is a former employee of and hold equity interests or options to obtain equity interests in (Emulate Inc). WT is a current employee of and hold equity interests or options to obtain equity interests in (Emulate Inc). DM Is a current employee of and hold equity interests or options to obtain equity interests in (Emulate Inc). CB, AR Is an inventor on a patent application (P16451EP00/16/912,391) submitted by Hoffmann-LaRoche and Emulate that covers 'Method for Assessing a Compound Interacting with a Target on Epithelial Cells'. Employment, patents and ownership of stock with Roche. GH Is a current or former employee of and hold equity interests or options to obtain equity interests in (Emulate Inc). Is an inventor on a patent application (P16451EP00/16/912,391) submitted by Hoffmann-LaRoche and Emulate that covers 'Method for Assessing a Compound Interacting with a Target on Epithelial Cells', AM is an inventor on a patent application (P16451EP00/16/912,391) submitted by Hoffmann-LaRoche and Emulate that covers Method for Assessing a Compound Interacting with a Target on Epithelial Cells'. PB No competing interests declared, NG, LC is an inventor on a patent application (P16451EP00/16/912,391) submitted by Hoffmann-LaRoche and Emulate that covers Method for Assessing a Compound Interacting with a Target on Epithelial Cells'. Employment, patents and ownership of stock with Roche., (© 2021, Kerns et al.)