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CLDN18.2 bispecific antibodies represent a class of next-generation immunotherapy agents designed to treat solid tumors overexpressing Claudin 18.2 (CLDN18.2), a tight junction protein. These molecules typically feature a dual-binding architecture: one arm targets CLDN18.2 on the surface of tumor cells, while the second arm targets an immune cell receptor, most commonly CD3 (to engage T cells), CD47 (to block the "don't eat me" signal and engage macrophages), or CD28 (to provide co-stimulation). By bridging tumor cells and immune cells, these bispecific antibodies induce potent, localized immune activation and tumor cell lysis. CLDN18.2 is an attractive target due to its high expression in gastric, gastroesophageal junction, and pancreatic cancers, with limited expression in normal tissues. Several candidates are currently in early-phase clinical trials, including Akeso's AK132.
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