“…Bispecific antibodies, first conceptualized in 1983 (Milstein and Cuello, 1983 ), are antibodies that can bind two different antigens simultaneously. There are five fundamental groups of bispecific antibody formats: (i) asymmetric bivalent, bispecific IgG-like antibodies with heterodimeric heavy chains (HCs) (Ridgeway et al, 1996 ; Merchant et al, 1998 ; Gunasekaran et al, 2010 ; Strop et al, 2012 ; Klein et al, 2012 ; Labrijn et al, 2013 Von Kreudenstein et al, 2013 ; Brinkmann and Kontermann, 2017 ); (ii) tetravalent multispecific antibodies that are comprised of IgGs, with additional binding domains, e.g., scFvs, Fvs, VHH domains, or non-antibody binding scaffolds such as fynomers (Brack et al, 2014 ; Silacci et al, 2016 ), fused to either the N- or C-termini of either the heavy or light chains (LCs) (Coloma and Morrison, 1997 ); (iii) engineered binding domains within the normal IgG structure, such as the “two-in-one” bispecific approach from Genentech (Bostrom et al, 2009 ; Eigenbrot and Fuh, 2013 ) and the F-STAR approach of designing novel second binding sites within the C H 3 domain (Leung et al, 2015 ), (iv) engineered antibody fragments linked by short peptide linkers which can be made into bivalent, trivalent, or tetravalent formats addressing two to three targets (Mack et al, 1995 ; Holliger and Winter, 1997 ; Kipriyanov et al, 1999 ; Reusch et al, 2015 ; Egan et al, 2016 ). These may be fused to an Fc domain or other half-life extending molecule (Liu et al, 2017 ); and (v) IgGs that are chemically coupled to generate IgG-IgG conjugates (e.g., Brennan et al, 1985 ; Garrido et al, 1990 ).…”