Bispecific Single Domain Antibodies

Monoclonal antibodies are now widely recognized as therapeutic molecules and more than 25 molecules have been approved in the United States and other countries. Despite these successes, the clinical activity of these molecules is still far from optimal and new solutions have to be found, especially in the field of cancer therapy. The potential of bispecific antibodies, capable of simultaneously binding two different antigens has been clearly demonstrated over the years but the difficulty to produce large amounts of homogenous preparations has hindered a wider development of this approach. A variety of new recombinant formats is currently changing the situation. Single domain antibodies derived from IgG devoid of light chain naturally occurring in camelids and sharks, or produced by antibody engineering from human sources, are endowed with outstanding physical properties that qualifies them as ideal building blocks to elaborate multivalent and/or multispecific molecules. This chapter aims at giving an overview of the published work using single domain antibodies to create bispecific antibodies.