Table 1 Advantages and disadvantages of polyspecific antibodies over monospecific antibodies

Amenable for large scale production

Hetero-dimerization of chains may make the molecule inefficient; early methods had low production yields

More efficient binding to target

Steric inhibition of engaging sites

Able to engage T cell or NK cells (MHC agnostic) by a cell combining site

Potential antigenic cytokine release syndrome

Stability

Small molecules can be rapidly cleared; larger ones may aggregate; potential immunogenicity

Not patient specific; target specific

Tight white cell binding may change bio-distribution

Can be a carrier of radioisotope or chemotherapy

Potential poor internalization of molecule if combined with cytotoxic agent

Can be used for imaging

Need for external epitope

Can serve as an immune enhancer

Affinity for target epitope and effector cell critical

Can be encapsulated in a liposome

Large molecules have less intra-tumoral penetration.

Can be combined with other immunological agents

May enhance toxicity if combined with classical immunological agents

Bystander effect