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(12) United States Patent (10) Patent No.: US 9,499,622 B2 Cheong et al. (45) Date of Patent: Nov. 22, 2016

(54) ANTI-EGFR/ANTI-HER2 BISPECIFIC 5,821,337 A 10, 1998 Carter et al. WITH ANT-EGFR DARPNS 6,165,464 A 12/2000 Hudziak et al. 7,417,130 B2 8/2008 Stumpp et al. 8,071,730 B2 12/2011 Goetsch et al. (71) Applicant: Samsung Electronics Co., Ltd., 8, 110,653 B2 2/2012 Stumpp et al. Suwon-si, Gyeonggi-do (KR) 8,329,873 B2 12/2012 Adams et al. 8,524,244 B2 9/2013 Camphausen et al. (72) Inventors: Kwang Ho Cheong, Seoul (KR): 9,234,028 B2 1/2016 Camphausen et al. Seung Hyun Lee, Suwon-si (KR): 9,359.440 B2 * 6/2016 Cheong ...... CO7K 14,705 Powei Lin, Hwaseong-si (KR); Saet 2009/0010840 A1 1/2009 Adams et al. Byoul Lee, Seoul (KR); Jae Woong 2010/0178298 A1 7/2010 Lindhofer 2012fOO2O966 A1* 1/2012 Barbas, III ...... CO7K 14,515 Hwang, Seoul (KR) 424,134.1 2012/0156191 A1 6/2012 Goetsch et al. (73) Assignee: SAMSUNGELECTRONICS CO., 2012,0277143 A1 1 1/2012 Jacobs et al. LTD., Suwon-Si (KR) 2013, OO17200 A1 1/2013 Scheer et al. 2015.OO30596 A1* 1/2015 Cheong ...... CO7K 14,705 (*) Notice: Subject to any disclaimer, the term of this 424,134.1 patent is extended or adjusted under 35 U.S.C. 154(b) by 0 days. FOREIGN PATENT DOCUMENTS EP 1332.209 B2 11/2009 (21) Appl. No.: 14/625,296 EP 21496.04 A1 2, 2010 JP 2011-5 17314 A 6, 2011 (22) Filed: Feb. 18, 2015 KR 2009-0088878 A 8, 2009 KR 2012-01.23299. A 11 2012 (65) Prior Publication Data WO WO 2012/069655 A2 5, 2012 US 2015/O232573 A1 Aug. 20, 2015 OTHER PUBLICATIONS (30) Foreign Application Priority Data HogenEsch et al. J. Controlled Release 2012; 164:183-186.* Tang et al. Cancer Letters 2016; 370:85-90.* Feb. 18, 2014 (KR) ...... 10-2014-0018649 Kataja et al., Ann Oncol 2009; 20(sup 4): ivl 0-14.* Nelson et al., Ann. Intern Med. 2009; 151:727-737.* (51) Int. Cl. Balmana et al. Ann Oncol 2009; 20(supp 4):iv19-20.* C07K 6/30 (2006.01) Boersma et al., J. Biol. Chem., 2011:286: 41273-85.* Steiner et al. J. Mol. Biol. 2008; 382:1211-27 and Supplemental A 6LX 39/395 (2006.01) Figures.* C07K 6/28 (2006.01) C07K 6/32 (2006.01) * cited by examiner (52) U.S. Cl. CPC ...... C07K 16/2863 (2013.01); C07K 16/32 Primary Examiner — Jessica H Roark (2013.01); C07K 23.17/31 (2013.01); C07K (74) Attorney, Agent, or Firm — Leydig, Voit & Mayer, 2317/73 (2013.01); C07K 2317/77 (2013.01); Ltd. C07K 2317/92 (2013.01) (58) Field of Classification Search (57) ABSTRACT CPC ...... C07K 16/00–16/468; C07K 23.17/31 An anti-EGFR/anti-HER2 bispecific including an See application file for complete search history. anti-EGFR DARPin and an anti-HER2 antibody, a pharma ceutical composition including the bispecific antibody, a (56) References Cited method of preparing the bispecific antibody, and a method of U.S. PATENT DOCUMENTS reducing a side effect and/or enhancing efficacy of an anti-HER2 antibody using an anti-EGFR DARPin. 5,677,171 A 10, 1997 Hudziak et al. 5,772,997 A 6, 1998 Hudziak et al. 19 Claims, 5 Drawing Sheets U.S. Patent Nov. 22, 2016 Sheet 1 of 5 US 9,499,622 B2

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US 9,499,622 B2 1. 2 ANT-EGFR/ANTI- HER2 BISPECIFIC Another embodiment provides a pharmaceutical compo ANTIBODES WITH ANT-EGFR DARPNS sition including the bispecific antibody. Another embodiment provides a method of preventing CROSS-REFERENCE TO RELATED and/or treating a cancer including administering the bispe APPLICATIONS cific antibody to a subject in need of preventing and/or treating the cancer. This application claims the benefit of Korean Patent Another embodiment provides a method of reducing a Application No. 10-2014-0018649 filed on Feb. 18, 2014, in side effect (such as agonism) and/or enhancing an efficacy of the Korean Intellectual Property Office, the entire disclosure an anti-HER2 antibody, including binding a DARPinto the of which is hereby incorporated by reference. 10 antibody. INCORPORATION-BY-REFERENCE OF BRIEF DESCRIPTION OF THE DRAWINGS MATERIAL ELECTRONICALLY SUBMITTED FIG. 1 is a schematic view showing processes of prepar Incorporated by reference in its entirety herein is a com 15 ing an anti-EGFR/anti-HER2 bispecific antibody. puter-readable nucleotide? sequence listing Sub FIG. 2 is a graph showing properties of an anti-EGFR/ mitted herewith and identified as follows: One 18,994 bytes anti-HER2 bispecific antibody. ASCII (Text) file named “719349 ST25-revised.TXT,” cre FIG. 3 is a graph showing the degree of proliferation ated Feb. 18, 2015 Apr. 29, 2016. inhibition of MKN45 cells by an anti-EGFR/anti-HER2 bispecific antibody. BACKGROUND OF THE INVENTION FIG. 4 is a graph showing the degree of proliferation inhibition of SNU638 cells by an anti-EGFR/anti-HER2 1. Field bispecific antibody. Provided is an anti-EGFR/anti-HER2 bispecific antibody 25 FIG. 5 is a graph showing the degree of proliferation including an anti-EGFR DARPin and an anti-HER2 anti inhibition of N87 cells by an anti-EGFR/anti-HER2 bispe body, a pharmaceutical composition including the bispecific cific antibody. antibody, a method of preparing the bispecific antibody, and FIG. 6 is a set of fluorescence images showing internal a method of reducing a side effect and/or enhancing an ization of EGFR and HER2 by an anti-EGFR/anti-HER2 efficacy of an anti-HER2 antibody using an anti-EGFR 30 bispecific antibody. DARPin. 2. Description of the Related Art DETAILED DESCRIPTION OF THE In living cells, various interact with each other INVENTION and are participants in various disease-causing mechanisms. If at least two of such proteins are simultaneously inhibited, 35 Bispecific antibodies have been developed in various a greater effect of treating a disease and a greater possibility kinds and forms and are expected as a new drug antibody of overcoming a resistance against an inhibitor against each having excellent therapeutic effects compared to pre-exist can be obtained, compared with the case of inhib ing monoclonal antibodies, due to its dual (multi-) binding iting a single protein. For these reasons, various antibodies activity to at least two different antigens. Herein, a bispecific capable of inhibiting at least two proteins have been devel 40 antibody obtained by binding a DARPinto an IgG form oped. antibody is disclosed. Although many bispecific antibodies have been devel DARPin (designed repeat protein) refers to an oped, most of the bispecific antibodies cannot be commer protein having high specificity and high cialized as antibody medicaments, because their therapeutic binding affinity to a target protein, which is prepared via effects are not clinically verified or various side effects are 45 . DARPin is originated from natural observed. In addition, the developed bispecific antibodies ankyrin protein, and has a structure where at least 2 or at have defects in stability and large scale production, which is least 3 motifs, for example, 3, 4, 5, 6, 8 or 10 an obstacle in commercialization. The early developed ankyrin repeat motifs are repeated. For example, the bispecific antibodies having IgG form have difficulties in DARPins including 3, 4 or 5 ankyrin repeat motifs may have isolation and purification, since light chains and heavy 50 a molecular weight of about 10 kDa, about 14 kDa, and chains are randomly combined during producing processes, about 18 kDa, respectively. DARPin includes a core part leading to problems in large scale production. In addition, in which acts structural function and a target binding part the case of bispecific antibodies having other form than IgG, outside of the core which binds to a target. The core part the stability as a medicine in respect of protein folding, includes conserved amino acid sequence and the target pharmacokinetics, and the like has not been Verified. 55 binding part, which is positioned outside of the core part, Therefore, there is a need for developing a bispecific includes different amino acid sequence depending on the antibody having increased stability and improved properties target. as a medicine. DARPin has target specificity, which is similar to an antibody, and thus, a new form of a bispecific antibody can BRIEF SUMMARY OF THE INVENTION 60 be made by attaching at least one DARPinto an antibody having various forms such as an IgG (e.g., IgG1, IgG2, IgG3 One embodiment provides a bispecific antibody against or IgG4) form, a schv-Fc form, and the like. EGFR and HER2, including an anti-EGFR DARPin and an The “EGFR (epidermal growth factor receptor) is a anti-HER2 antibody. member of the receptor tyrosine kinases (RTKs) of HER Another embodiment provides a method of preparing a 65 family. Over-expression, gene amplification, mutation, or bispecific antibody against EGFR and HER2, including rearrangement of EGFR are frequently observed in several linking an anti-HER2 antibody and an anti-EGFR DARPin. human malignant tumors and are related to poor prognosis US 9,499,622 B2 3 4 of cancer treatment and bad clinical outcomes. For Such growth factor binds thereto, leading to activation of various reasons, the EGFR becomes an important target in antican signal transduction pathways, thereby inducing apoptosis, cer . survival, or proliferation of cells. Therefore, in an embodiment, provided is a fusion protein The HER2 protein may be originated from a mammal, for comprising or consisting essentially of an anti-EGFR DAR example, HER2 originated from primates, such as human Pin (or an EGFR binding DARPin) which specifically binds HER2, monkey HER2, and the like, or HER2 originated to EGFR and an anti-HER2 antibody. The fusion protein from rodents, such as mouse HER2, rat HER2, and the like. may be used as a bispecific antibody specifically recognizing For example, the HER2 protein may be human HER2 (e.g., and/or binding to EGFR and HER2. Therefore, another encoded by the nucleotide sequence (mRNA) of GenBank embodiment provides an anti-EGFR/anti-HER2 bispecific 10 antibody comprising or consisting essentially of an anti Accession Number NM 004448), mouse HER2 (e.g., EGFR DARPin and an anti-HER2 antibody. The anti-HER2 encoded by the nucleotide sequence (mRNA) of GenBank antibody may be in an IgG form, a schv-Fc form, or a Accession Number NM_001003817), or rat HER2 (e.g., combination thereof. As used herein, the term “IgG form’ encoded by the nucleotide sequence (mRNA) of GenBank may refer to a protein complex composed of four peptide 15 Accession Number NM 017003). chains, i.e., two identical heavy chains and two identical The antibody having an IgG form may be in a form of light chains, arranged in a Y-shape. As used herein, the term IgG1, IgG2, IgG3 or IgG4 Subtype of a mammal, for “schv-Fc' may refer to an antibody fragment comprising example, IgG1 or IgG2 subtype. The antibody having an IgG ScFv (single-chain variable fragment; a fusion protein of the form includes two heavy chains and two light chains, and the variable regions of the heavy (generally at N-terminus) and heavy chain and the light chain are linked to each other via light chains (generally at C-terminus) of immunoglobulins, disulfide bond, forming two heavy chain-light chain struc connected with each other directly (through a covalent bond tures. The formed two heavy chain-light chain structures are Such as a peptide bond) or via a peptide linker) and Fc region linked to each other at Fc region of the heavy chain via (fragment crystallizable region) which is linked to the C-ter disulfide bond. minus of the scFv directly (through a covalent bond such as 25 a peptide bond) or via a peptide linker. The antibody having a scFv-Fc form may be in a mono The anti-EGFR DARPin may be any DARPin having meric form comprising a Sclv-Fc fragment comprising an DARPin's own unique structure and specifically binding to antigen-binding region specifically recognizing and/or bind EGFR. For example, the anti-EGFR DARPin may include at ing to HER2 or in a dimeric form comprising two scFv-Fc least one selected from the group consisting of the following 30 fragments comprising antigen-binding regions specifically four anti-EGFR DARPins: recognizing and/or binding to HER2, where the two schv-Fc fragments are linked to each other at Fc region. The Fc region may be derived from subtype IgG1, IgG2, IgG3 or anti-EGFR DARPin- O1 (SEQ ID NO: 1) : IgG4 of a mammal, for example, IgG1 or IgG2. diligkkilleaaragoddevrilmangadvnaddtwdwtp.lhlaaygghlei 35 IgG1, IgG2, IgG3, or IgG4 may originate from a mam vevillking advnaydyigwtp.lhlaadghlei vevillking advnasdyig mal. Such as a primate including human, a monkey, and the dtplhlaahnghileivevillkhgadvnaqdkfgktafdisidingnedlae like, or a rodent including a mouse, a rat, and the like, and for example, may be human IgG1, IgG2, IgG3, or IgG4 ild 40 Subtype. anti-EGFR DARPin- 67 (SEQ ID NO: 2) : The anti-HER2 antibody may be (1) an antibody or (2) an diligkkilleaaragoddevrilmangadvnatolindgntplhlsa Wighlei IgG type antibody or a scv-Fc type antibody comprising an antigen-binding region of the antibody (1), wherein the vevillkhgadvnaddllgmtp.lhlaadtghleivevillkygadvnardtr antibody (1) may be selected from the group consisting of 45 gktplhlaardghleivevillkhdadvnaqdkfgktafidisidingnedla i) trastuzumab comprising a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 7 and eild a light chain variable region comprising the amino acid anti-EGFR DARPin- 68 (SEQ ID NO : 3) : sequence of SEQ ID NO: 8, diligkkilleaaragoddevrilmangadvnafdywgmtp.lhlaadinghlei 50 ii) pertuZumab comprising a heavy chain comprising the vevillkhgadvnas dnfgiftpilhlaafyghleivevillkhgadvnafdmw amino acid sequence of SEQ ID NO: 9 and a light chain gntplhlaaqnghileivevillkingadvnaqdkfgktafidisidingnedla comprising the amino acid sequence of SEQ ID NO: 10, iii) trastuzumab emtansine (T-DM1), and eild 55 iv) an anti-HER2 antibody comprising a heavy chain anti-EGFR DARPin- 69 (SEQ ID NO : 4) : variable region comprising the amino acid sequence of SEQ diligkkilleaaragoddevrilmangadvnaddnagirtplhlaanfghlei ID NO: 5 and a light chain variable region comprising the vevillking advnakghhentiplhlaawaghleivevillkygadvnaddde amino acid sequence of SEQ ID NO: 6. gytplhlaadigdleivevillkygadvnawdmygrtplhlaasaghleiv 60 (SEO ID NO; 5) HER2 (Human Epidermal growth factor Receptor 2 pro EVOLVESGGGLVOPGGSLRLSCAASGFNIKDTYIHWVROAPGKGLEWVAR tein) has been known to play an essential role in controlling IYPTNGYTRYADSVKGRFTISADTSKNTAYLOMNSLRAEDTAVYYCSRWG proliferation and differentiation of cells. In particular, HER2 65 strongly tends to assemble with other HER receptors to form GDGFYAMDYWGOGTLWTVSS a mono-dimer and/or hetero-dimer when extracellular US 9,499,622 B2 5 6 - Continued sequence, or at least two kinds of DARPins, for example, 2 to 10, 2 to 5, or 2 to 3 kinds of anti-EGFR DARPins, which include different amino acid sequences. When the anti (SEQ ID NO : 6) EGFR DARPins include different amino acid sequences, the DIOMTOSPSSLSASVGDRVTITCRASODVNTAVAWYOOKPGKAPKLLIYS 5 of EGFR recognized and/or bound by the anti-EGFR DARPins may be the same as or different from each other. ASFLYSGVPSRFSGSRSGTDFTL TISSLOPEDFATYYCOOHYTTPPTFGO In addition to the anti-EGFR DARPin, one or more GTKWEIKR DARPins, for example, 1 to 10 kinds, 1 to 5 kinds, or 1 to 3 kinds of DARPins, which target other protein than EGFR, The “an antigen-binding region' may refer to a polypep 10 may be further included in the bispecific antibody. When at tide comprising a region specifically binding to an antigen least two DARPins or at least two kinds of DARPins are (i.e., HER2), and for example, refer to a heavy chain CDR included, the at least two DARPins or the at least two kinds (complementarity determining region), a light chain CDR, a of DARPins may be linked to each other to form a repeated heavy chain variable region, a light chain variable region, or form and then linked to the antibody (having an IgG form or a combination thereof (e.g., sclv, (scFV)2, Fab, Fab', or 15 a schv-Fc from) in the repeated form, where the DARPins F(ab')2)) of an anti-HER2 antibody. or the repeated form may be linked to at least one of The anti-EGFR DARPin may be linked (bound) to C-ter C-terminus, N-terminus, and other linkable site of each minus, N-terminus, or any linkable site of an anti-HER2 chain of the antibody having an IgG form or a scFv-Fc from. antibody having an IgG form or a Schv-Fc form (an IgG type For example, the anti-EGFR DARPin may be a repeated anti-HER2 antibody or a schv-Fc type anti-HER2 antibody). form, wherein one or more anti-EGFR DARPins selected For example, in order to preserve the antigen-binding ability from the group consisting of anti-EGFR DARPins compris of the antibody having an IgG form or a schv-Fc form, the ing the amino acid sequence of SEQID NOs: 1, 2, 3, and 4 anti-EGFR DARPin may be linked to C-terminus of Fc are repeated 1 to 10 times, 1 to 5 times, or 1 to 3 times, and region of an IgG type anti-HER2 antibody or a schv-Fc type in this case, the repeated form of anti-EGFR DARPins may anti-HER2 antibody, but not be limited thereto. The anti 25 be linked to C-terminus, N-terminus, and other linkable site, EGFR DARPin and the anti-HER2 antibody having an IgG for example, C-terminus of a heavy chain (e.g., Fc region) form or a scFv-Fc form (an IgG type anti-HER2 antibody or or C-terminus of a light chain, of the antibody having an IgG a scFv-Fc type anti-HER2 antibody) may be linked (bound) form and/or a scFv-Fc from. to each other directly (through a covalent bond Such as a A DARPin and an antibody (e.g., an anti-HER2 antibody) peptide bond) or via a proper linker Such as a peptide linker. 30 in an IgG form and/or in a scFV-Fc form; a heavy chain If the bispecific antibody comprises an anti-EGFR DAR variable region and a light chain variable region in the Pin and a combination of an antibody having an IgG form scFv-Fc; and a scFv-Fc and a scFv-Fc (in case of forming a and an antibody having a schv-Fc form, the anti-EGFR dimer) may be linked to each other with a linker or without DARPin, the antibody having an IgG form, and the antibody a linker (directly, for example, through a peptide bond). The having a scFV-Fc form may be linked in any order. Although 35 linker may be a peptide linker, and if two or more linkers are in Some cases, the efficacy or expression rate of the bispe used, the linkers may be the same with or different from each cific antibody may vary depending on the linking order, in other. The peptide linker may comprise 1 to 100 or 2 to 50 general cases, the linking order has no effect on the desired of random amino acids, and the kinds of the amino acids efficacy of the bispecific antibody. For example, the bispe comprised in the peptide linker may not have any limitation. cific antibody may comprise an anti-HER2 antibody having 40 For example, the peptide linker may include Gly, ASn and/or an IgG form, an anti-EGFR DARPin linked to the C-termi Ser residues, or may include neutral amino acids such as Thr nus of the anti-HER2 antibody having an IgG form, and an and/or Ala. Amino acid sequences suitable for a peptide anti-HER2 antibody having a schv-Fc form linked to C-ter linker may be well known in the relevant art. The length of minus of the anti-EGFR DARPin, but is not limited thereto. the peptide linker may be properly determined so that there Another embodiment provides a method of preparing an 45 is no effect on the function of the bispecific antibody. For anti-EGFR/anti-HER2 bispecific antibody, comprising link example, the peptide linker may include at least one amino ing an anti-EGFR DARPin and an anti-HER2 antibody. The acid selected from the group consisting of Gly, ASn, Ser, Thr, step of linking an anti-EGFR DARPin and an anti-HER2 and Ala, wherein the total number of the amino acid may be antibody may performed by linking the anti-EGFR DARPin, 1 to 100, 2 to 50, or 5 to 25. One embodiment, the peptide and an anti-HER2 antibody having an IgG form, an anti 50 linker may be represented as (G4S)n (wherein “n” is HER2 antibody having or a schv-Fc form, or a combination repeated number of (G4S), and an integer from 1 to 10, e.g., thereof. When at least two anti-EGFR DARPins are linked, an integer from 2 to 5). the method may further comprise linking (e.g., linking in Since the DARPin has high affinity to an antigen (target), series) at least two of anti-EGFR DARPins (for example, 2 and higher stability and Smaller molecular weight than those to 10, 2 to 5, or 2 to 3 anti-EGFR DARPins, which include 55 of general antibody fragment (e.g., ScPv, Fab, etc.), the the same amino acid sequence, or at least two kinds of DARPin is advantageous in respect of properties (such as DARPins, for example, 2 to 10, 2 to 5, or 2 to 3 kinds of pharmacokinetic (PK) properties in the living body) and anti-EGFR DARPins, which include different amino acid stability in the living body. In addition, the DARPin can be sequences) to each other, before or after the step of linking readily fused with other protein. Therefore, the DARPin can the anti-EGFR DARPin, and an anti-HER2 antibody having 60 be useful in preparing a bispecific antibody having excellent an IgG form, an anti-HER2 antibody having a scFv-Fc form, properties and stability in the body. or a combination thereof. The anti-HER2 antibody may be EGFR and HER2, which interact with each other, are an antibody having an IgG form, an antibody having a representative receptor tyrosine kinase proteins and partici scFv-Fc form, or a combination thereof. pate in various tumor-related mechanisms. These proteins The bispecific antibody may comprise at least one anti 65 can induce proliferation of cancer cells, penetration of EGFR DARPin, for example, 1 to 10, 1 to 5, or 1 to 3 cancer cells, angiogenesis, etc. In addition, these proteins anti-EGFR DARPins, which include the same amino acid interact with each other and participate in each other's signal US 9,499,622 B2 7 8 transduction systems, thereby inducing resistance to treat gamma 3 (Y3), gamma 4 (Y4), alpha 1 (C.1), or alpha 2 (O2). ment of each individually. In addition, the resistance The light chain constant region is of either a kappa (K) or acquired by administration of an EGFR-targeting treatment lambda (W) type. (Erbitux, Tarceva, Iresa, etc.) is related to over-expression As used herein, the term “heavy chain” refers to full and mutation of HER2. Therefore, simultaneous inhibition length heavy chain, and fragments thereof, including a of EGFR and HER2 may achieve an increased possibility of variable region V that includes amino acid sequences overcoming many problems of pre-existing treatments. Such Sufficient to provide specificity to antigens, and three con as side effects, resistances, and the like, as well as increased stant regions, C, C2, and C, and a hinge. The term therapeutic effect compared to the case of inhibition of a “light chain” refers to a full-length light chain and fragments single target. Thus, it is expected that therapeutic effects on 10 thereof, including a variable region V, that includes amino cancer, on which pre-existing treatments have no therapeutic acid sequences Sufficient to provide specificity to antigens, effects, can be obtained by simultaneously inhibiting EGFR and a constant region C. and HER2. The term “complementarity determining region (CDR) In addition, the bispecific antibody may make it possible 15 refers to an amino acid sequence found in a hyper variable to overcome (acquired) resistance to an anti-HER2 antibody region of a heavy chain or a light chain of immunoglobulin. or an EGFR targeting medicament such as an anti-EGFR The heavy and light chains may respectively include three antibody, thereby being capable of exhibiting the (antican CDRs (CDRH1, CDRH2, and CDRH3; and CDRL1, cer) effect even on a cell having the resistance. Therefore, CDRL2, and CDRL3). The CDR may provide contact the bispecific antibody comprising an anti-EGFR DARPin residues that play an important role in the binding of and anti-HER2 antibody may have a more increased effect antibodies to antigens or . The terms "specifically by a degradation mechanism which is distinguished from a binding and “specifically recognized are well known to pre-existing mechanism. one of ordinary skill in the art, and indicate that an antibody Animal-derived antibodies produced by immunizing non and an antigen specifically interact with each other to lead to immune animals with a desired antigen generally invoke 25 an immunological activity. immunogenicity when injected to humans for the purpose of The term “antigen-binding fragment used herein refers to medical treatment, and thus chimeric antibodies have been fragments of an intact immunoglobulin including portions of developed to inhibit such immunogenicity. Chimeric anti a polypeptide including antigen-binding regions having the bodies are prepared by replacing constant regions of animal ability to specifically bind to the antigen. In a particular derived antibodies that cause an anti-isotype response with 30 embodiment, the antigen-binding fragment may be Sclv, constant regions of human antibodies by genetic engineer (scFv), scEv-Fc, Fab, Fab', or F(ab'), but is not limited ing. Chimeric antibodies are considerably improved in an thereto. anti-isotype response compared to animal-derived antibod Among the antigen-binding fragments, Fab that includes ies, but animal-derived amino acids still have variable 35 light chain and heavy chain variable regions, a light chain regions, so that chimeric antibodies have side effects with constant region, and a first heavy chain constant region C. respect to a potential anti-idiotype response. Humanized has one antigen-binding site. antibodies have been developed to reduce such side effects. The Fab' fragment is different from the Fab fragment, in Humanized antibodies are produced by grafting comple that Fab' includes a hinge region with at least one mentarity determining regions (CDR) which serve an impor 40 residue at the C-terminal of C. tant role in antigen binding in variable regions of chimeric The F(ab') antibody is formed through disulfide bridging antibodies into a human antibody framework. of the cysteine residues in the hinge region of the Fab' An important consideration in CDR grafting to produce fragment. humanized antibodies is choosing the optimized human Fv is the smallest antibody fragment with only a heavy antibodies for accepting CDRs of animal-derived antibodies. 45 chain variable region and a light chain variable region. Antibody databases, analysis of a crystal structure, and Recombination techniques of generating the Fv fragment are technology for molecule modeling are used. However, even widely known in the art. when the CDRs of animal-derived antibodies are grafted to Two-chain Fv includes a heavy chain variable region and the most optimized human antibody framework, amino acids a light chain region which are linked by a non-covalent positioned in a framework of the animal-derived CDRs 50 bond. Single-chain Fv (scFV) generally includes a heavy affecting antigen binding are present. Therefore, in many chain variable region and a light chain variable region which cases, antigen binding affinity is not maintained, and thus are linked to each other by a covalent bond via a peptide application of additional antibody engineering technology linker or directly between the C-terminus of the heavy chain for recovering the antigen binding affinity is necessary. variable region and the N-terminus of the light chain vari The anti HER2 antibodies may be mouse-derived anti 55 able region or the C-terminus of the light chain variable bodies, mouse-human chimeric antibodies, humanized anti region and the N-terminus of the heavy chain variable bodies, or human antibodies. The antibodies or antigen region, to have a dimer structure like the two-chain Fv. The binding fragments thereof may be isolated from a living peptide linker may be the same as described herein, for body or non-naturally occurring. The antibodies or antigen example, those including the amino acid length of 1 to 100, binding fragments thereof may be recombinant or synthetic. 60 2 to 50, particularly 5 to 25, and any kinds of amino acids An intact antibody includes two full-length light chains may be included without any restrictions. and two full-length heavy chains, in which each light chain The antigen-binding fragments may be attainable using is linked to a heavy chain by disulfide bonds. The antibody protease (for example, the Fab fragment may be obtained by has a heavy chain constant region and a light chain constant restricted cleavage of a whole antibody with papain, and the region. The heavy chain constant region is of a gamma (Y), 65 F(ab')2 fragment may be obtained by cleavage with pepsin), mu (), alpha (C), delta (Ö), or epsilon (e) type, which may or may be prepared by using a genetic recombination be further categorized as gamma 1 (y1), gamma 2 (Y2). technique. US 9,499,622 B2 9 10 The term “hinge region,” as used herein, refers to a region which includes a scFV-Fc fragment including an antigen between CH1 and CH2 domains within the heavy chain of binding region for HER2 and a schv-Fc fragment including an antibody which functions to provide flexibility for the an antigen-binding region for an antigen other than HER2, antigen-binding site. where the two scFv-Fc fragments are linked to each other at When an animal antibody undergoes a chimerization Fc region. The antigen other than HER2 may be an EGFR. process, the IgG1 hinge of animal origin is replaced with a Another embodiment provides a method of preparing a human IgG1 hinge or IgG2 hinge while the disulfide bridges fusion protein or an anti-EGFR/anti-HER2 bispecific anti between two heavy chains are reduced from three to two in body, comprising linking an anti-EGFR DARPin and an number. In addition, an animal-derived IgG1 hinge is shorter anti-HER2 antibody. The step of linking an anti-EGFR than a human IgG1 hinge. Accordingly, the rigidity of the 10 DARPin and an anti-HER2 antibody may performed by hinge is changed. Thus, a modification of the hinge region linking an anti-EGFR DARPin, and an anti-HER2 antibody may bring about an improvement in the antigen binding having an IgG form, an anti-HER2 antibody having or a efficiency of the humanized antibody. The modification of scFv-Fc form, or a combination thereof. When at least two the hinge region through amino acid deletion, addition, or anti-EGFR DARPins are linked, the method may further substitution is well-known to those skilled in the art. 15 comprise linking (e.g., linking in series) at least two of In one embodiment, the anti-HER2 antibody or an anti anti-EGFR DARPins (for example, 2 to 10, 2 to 5, or 2 to gen-binding fragment thereof may be modified by the dele 3 anti-EGFR DARPins, which include the same amino acid tion, insertion, addition, or Substitution of at least one amino sequence, or at least two kinds of DARPins, for example, 2 acid residue on the amino acid sequence of the hinge region to 10, 2 to 5, or 2 to 3 kinds of anti-EGFR DARPins, which so that it exhibits enhanced antigen-binding efficiency. For include different amino acid sequences) to each other, before example, the antibody may include a hinge region including or after the step of linking the anti-EGFR DARPin, and an the amino acid sequence of SEQ ID NO: 11 (UT-HC6), 12 anti-HER2 antibody having an IgG form, an anti-HER2 (U6-HC7), 13 (U3-HC9), 14 (U6-HC8), or 15 (U8-HC5), or antibody having a schv-Fc form, or a combination thereof. a hinge region including the amino acid sequence of SEQID The anti-HER2 antibody may be an antibody having an IgG NO: 16 (non-modified human hinge). In particular, the hinge 25 form, an antibody having a scFV-Fc form, or a combination region has the amino acid sequence of SEQID NO: 11 or 12. thereof. For example, the step of linking an anti-EGFR The anti-HER2 antibody having an IgG form may be a DARPin and an anti-HER2 antibody may performed by monospecific antibody (single targeting antibody) including expressing a recombinant vector in a proper host cell, an antigen-binding region (e.g., a heavy chain CDR, a light wherein the recombinant vector comprises a polynucleotide chain CDR, a heavy chain variable region, a light chain 30 encoding the anti-EGFR DARPin, a polynucleotide encod variable region, or a combination thereof) for HER2 at both ing the anti-HER2 antibody having an IgG form (i.e., a of the two heavy chain-light chain structures. Alternatively, heavy chain and a light chain of the anti-HER2 antibody) or the anti-HER2 antibody having an IgG form may be a a scFv-Fc form, or a combination thereof. bispecific antibody targeting two antigens (dual targeting Another embodiment provides a pharmaceutical compo antibody) including an antigen-binding region (e.g., a heavy 35 sition comprising the bispecific antibody as an active ingre chain CDR, a light chain CDR, a heavy chain variable dient. Another embodiment provides a pharmaceutical com region, a light chain variable region, or a combination position for preventing and/or treating a cancer comprising thereof) for HER2 at one of the two heavy chain-light chain the bispecific antibody as an active ingredient. Another structures, and an antigen-binding region for an antigen embodiment provides a method of preventing and/or treating other than HER2 at the other heavy chain-light chain struc 40 a cancer comprising administering the bispecific antibody to ture. In this case, the antigen other than HER2 may be an a Subject in need of preventing and/or treating a cancer. In EGFR. the method, the bispecific antibody may be administered in In another embodiment, the anti-HER2 antibody having a pharmaceutically effective amount for preventing and/or an IgG form may be a top and bottom asymmetric bispecific treating a cancer. The method may further comprise a step of antibody which includes a monospecific antibody in a IgG 45 identifying the Subject in need of preventing and/or treating form including an antigen-binding region for HER2 at both a cancer, prior to the step of administering. Another embodi of the two heavy chain-light chain structures and an antigen ment provides a use of the bispecific antibody for preventing binding region (e.g., a heavy chain CDR, a light chain CDR, and/or treating a cancer. a heavy chain variable region, a light chain variable region, The cancer may be a solid cancer or hematological cancer or a combination thereof (e.g., sclv, (scFV)2, Fab, Fab', or 50 and for instance, may be, but is not limited to, one or more F(ab')2)) for an antigen other than HER2 linked to C-ter selected from the group consisting of squamous cell carci minus of Fc of the monospecific antibody in a IgG form with noma, Small-cell lung cancer, non-Small-cell lung cancer, or without a linker. In this case, the antigen other than HER2 adenocarcinoma of the lung, squamous cell carcinoma of the may be an EGFR. The linker is described as above. lung, peritoneal carcinoma, skin cancer, melanoma in the In another embodiment, the anti-HER2 antibody may be 55 skin or eyeball, rectal cancer, cancer near the anus, esopha an antibody having a schv-Fc form. The anti-HER2 antibody gus cancer, Small intestinal tumor, endocrine gland cancer, having a scFV-Fc form may be a monospecific antibody in parathyroid cancer, adrenal cancer, soft-tissue sarcoma, ure a monomeric form for targeting HER2, which includes one thral cancer, chronic or acute leukemia, lymphocytic lym ScFV-Fc fragment including an antigen-binding region (e.g., phoma, hepatoma, gastric cancer, gastrointestinal cancer, a heavy chain CDR, a light chain CDR, a heavy chain 60 pancreatic cancer, glioblastoma, cervical cancer, ovarian variable region, a light chain variable region, or a combi cancer, liver cancer, bladder cancer, hepatocellular nation thereof) for HER2; a monospecific antibody in a adenoma, breast cancer, colon cancer, large intestine cancer, homodimeric form for targeting a single antigen, which endometrial carcinoma or uterine carcinoma, salivary gland includes two scEv-Fc fragments including antigen-binding tumor, kidney cancer, prostate cancer, Vulvar cancer, thyroid regions for HER2, where the two scFv-Fc fragments are 65 cancer, head or neck cancer, brain cancer, osteosarcoma, and linked to each other at Fc region; or a bispecific antibody in the like. In particular, the cancer may be cancer having a heterodimeric form for targeting HER2 and other antigen, resistance against pre-existing anticancer drugs, for US 9,499,622 B2 11 12 example, antagonists against EGFR. The prevention and/or dylethanolamine, and may be prepared by a reverse phase treatment effects of the cancers may include effects of not evaporation method. For example, Fab' fragments of an only Suppressing the growth of the cancer cells but also antibody may be conjugated to the liposome through a Suppressing progression of cancers due to migration, inva disulfide exchange reaction. A chemical drug Such as doxo Sion, and metastasis thereof. Therefore, the curable cancers rubicin may be additionally included in the liposome. may include both primary cancers and metastatic cancers. The Subject to which the pharmaceutical composition or The bispecific antibody may be administered or formu the bispecific antibody is administered or the patient to lated along with a pharmaceutically acceptable carrier, which the prevention and/treatment method is applied may diluent, and/or excipient. be a mammal, for example, a primate Such as human and The pharmaceutically acceptable carrier to be included in 10 monkey, or a rodent Such as rat and mouse, but are not be the composition may be those commonly used for the limited thereto. The subject or the patient may be a cancer formulation of antibodies, which may be one or more patient having resistance against pre-existing anticancer selected from the group consisting of lactose, dextrose, drugs, for example, EGFR antagonists (e.g., an anti-EGFR Sucrose, Sorbitol, mannitol, starch, gum acacia, calcium antibody, etc.) and/or an anti-HER2 antibody. phosphate, alginates, gelatin, calcium silicate, micro-crys 15 As described above, DARPin has an excellent properties talline cellulose, polyvinylpyrrolidone, cellulose, water, (e.g., pharmacokinetic (PK) properties) and stability in the syrup, methyl cellulose, methylhydroxy benzoate, propyl body, and thus, when it is fused (linked) with a pre-existing hydroxybenzoate, talc, magnesium Stearate, and mineral oil, antibody (e.g., an antibody in an IgG form) to prepare a but are not limited thereto. The pharmaceutical composition bispecific antibody, it can be achieved not only to simulta may further include one or more selected from the group neously target at least two antigens including the target of consisting of a lubricant, a wetting agent, a Sweetener, a the DARPin but also to enhance the properties and/or flavor enhancer, an emulsifying agent, a suspension agent, stability of the antibody in an IgG form. That is, by fusing and preservative. a DARPin and a pre-existing antibody in an IgG form, the The pharmaceutical composition or the bispecific anti defect in stability, which is the main problem of the pre body may be administered orally or parenterally. The par 25 existing bispecific antibody, can be solved, and more enteral administration may include intravenous injection, increased effect can be achieved. Subcutaneous injection, muscular injection, intraperitoneal Accordingly, another embodiment provides a method of injection, endothelial administration, local administration, enhancement of efficacy or an effect of an anti-HER2 intranasal administration, intrapulmonary administration, antibody, the method including binding (linking) (a) a DAR and rectal administration. Since oral administration leads to 30 Pinto (b) an anti-HER2 antibody having an IgG form, an digestion of proteins or peptides, an active ingredient in the anti-HER2 antibody having a scFv-Fc from, or a combina compositions for oral administration must be coated or tion thereof. The DARPin may be at least one anti-EGFR formulated to prevent digestion in stomach. In addition, the DARPin. compositions may be administered using an optional device The enhancement of an effect of an antibody (e.g., an that enables an active substance to be delivered to target 35 anti-HER2 antibody) may include at least one selected from cells. the group consisting of a synergistic effect obtained by A Suitable dosage of the pharmaceutical composition or targeting at least two antigen, improved properties as a the bispecific antibody may be prescribed in a variety of medicament Such as pharmacokinetic (PK) properties, ways, depending on factors such as formulation methods, increased Stability in vivo or ex vivo, overcoming resistance administration methods, age of patients, body weight, gen 40 to an anti-HER2 antibody, and decreased side effects of an der, pathologic conditions, diets, administration time, anti-HER2 antibody. administration route, excretion speed, and reaction sensitiv In the method of enhancement of an effect of an antibody, ity. A desirable dosage of the pharmaceutical composition or the DARPin, the anti-EGFR DARPin, the antibody having the bispecific antibody may be in the range of about 0.001 an IgG form, the antibody having an scFv-Fc form, and their to 100 mg/kg or 0.02 to 10 mg/kg per day for an adult. The 45 linkage form are described as above. term “pharmaceutically effective amount’ used herein refers According to Some embodiments, the bispecific antibody to an amount exhibiting effects in preventing or treating comprising an anti-EGFR DARPin and an anti-HER2 anti CaCC. body may have improved effects compared to pre-existing The pharmaceutical composition or the bispecific anti antibodies, for example, the pre-existing anti-HER2 anti body may be formulated with a pharmaceutically acceptable 50 body, as follows: carrier and/or excipient into a unit or a multiple dosage form 1. Novel application of EGFR DARPins, by a method easily carried out by a skilled person in the 2. Inhibition of EGFR activity by new MOA (mechanism pertinent art. The dosage form may be a solution in oil or an of action) aqueous medium, a suspension, syrup, an emulsifying solu 3. Synergistic anticancer effects compared to pre-existing tion, an extract, powder, granules, a tablet, or a capsule, and 55 anti-HER2 antibodies or anti-EGFR antagonists. may further include a dispersing or a stabilizing agent. 4. Anticancer effects on cancer cells having resistance to In addition, the pharmaceutical composition or the bispe pre-existing anti-HER2 antibodies or anti-EGFR antago cific antibody may be administered as an individual drug, or nists. together with other drugs, and may be administered sequen 5. Presentation of a bispecific antibody in an IgG tially in any order or simultaneously with pre-existing drugs. 60 DARPins form displaying excellent effects compared to Since the bispecific antibody or the pharmaceutical com combination therapy using an anti-EGFR antibody and an position includes an antibody or an antigenbinding fragment anti-HER2 antibody. thereof, it may be formulated as an immunoliposome. The liposome containing an antibody may be prepared using a EXAMPLES well-known method in the pertinent art. The immunolipo 65 Some is a lipid composition including phosphatidylcholine, Hereafter, the present invention will be described in detail cholesterol, and polyethyleneglycol-derivatized phosphati by examples. US 9,499,622 B2 13 14 The following examples are intended merely to illustrate Example 3 the invention and are not construed to restrict the invention. Examination of Cell Proliferation Inhibition of the Example 1 Anti-HER2/Anti-EGFR Bispecific Antibody Preparation of an Anti-HER2/Anti-EGFR DARPin In order to examine the cancer cell proliferation inhibition Bispecific Antibody effect of the bispecific antibody H2E-01 prepared in The anti-FGFRDARPins was fused the C-terminus of ExampleMKN's cline1, the degree KCBN of cell proliferationsolos), SNuoss was testedceilin. in EASHerceptin (Roche), R.S.S. to prepare an(i.e., anti-HER2 E. antibody/anti- 10" (KCLB No. 00683), and N87 cell line (ATCC No. CRL bispecific antibody) (FIG. 1). The heavy chain of HERCEP- 5822). TIN antibody and the anti-EGFR DARPin were linked to Each of the MKN45 cell line, SNU638 cell line, and N87 each other through a peptide linker having 10 amino acids cell line was cultured in RPMI1640 medium (#11875-093, (GGGGSGGGGS: (GS), SEQ ID NO: 17), to give “HER- 15 Gibco) supplemented with 10% (v/v) FBS and 1% (v/v) CEPTIN heavy chain-(GS)-anti-EGFR DARPins” form. Penicillin-Streptomycin under the conditions of 5% CO and The prepared anti-HER2/anti-EGFR bispecific antibody 37°C. To conduct cell proliferation assay, each cell line was was named as “H2E-01’. sub-cultured in 96-well plate at the concentration of 1x10' cell?well, treated with the anti-HER2/anti-EGFR DARPin Example 2 20 bispecific antibody H2E-01 prepared in Example 1 at the amount of 5 lug/ml, and further cultured for 72 hours. A Examination of Properties and EGFR Affinity of group treated with no antibody was used as a negative the Anti-HER2/Anti-EGFR DARPin Bispecific control. Groups treated with one of commercially obtained Antibody EGFR inhibitor, Erbitux (HET509081213, Merck; 5ug/ml), 25 HER2 inhibitor, HERCEPTIN antibody (Trastuzumab, To examine properties of the bispecific antibody H2E-01 Roche: 5 Lig/ml), or a combination thereof were used as (anti-HER2/anti-EGFR DARPin bispecific antibody) pre- positive controls. pared in Example 1, the bispecific antibody was purified and After culturing, the cell proliferation was measured by 20 ug of the bispecific antibody was injected to a HPLC Cell Counting Kit-8 assay (Dojindo Molecular Technolo system (WATERS 2695) equipped with TSKG3000SWXL 30 gies, Gaithersburg, Md.) according to the manufacturer's column (Tosho) to the velocity of 0/5 ml/min, to conduct a manual. In brief, after culturing for 72 hours, 10ul of CCK8 Size Exclusion Chromatography using HPLC. solution was added to each well, and further cultured 2.5 The obtained results are shown in FIG. 2. In FIG. 2. “1” hours. Then, the absorbance at 450 nm was measured using refers to a quantitative value of the peak for a soluble dimer, microplate reader. and "2" refers to a quantitative value of the peak for a 35 The obtained results are shown in FIG. 3 (MKN45), FIG. monomer. As shown in FIG. 2, the anti-HER2/anti-EGFR 4 (SNU638), and FIG. 5 (N87). As shown in FIGS. 3-5, the DARPin bispecific antibody H2E-01 prepared in Example 1 anti-HER2/anti-EGFR DARPin bispecific antibody H2E-01 forms very slight amount of Soluble dimer (<1), which exhibits excellent anticancer effect on gastric cancer cells demonstrates that the bispecific antibody is a very stable such as MKN45, SNU638, or N87, compared to Herceptin, molecule. 40 Erbitux, and the combination thereof. In addition, Herceptin The binding affinity of bispecific antibody H2E-01 to each cannot exhibit a meaningful inhibitory effect on proliferation of the two antigens HER2 and EGFR was examined using of gastric cells when administered alone, whereas when Biacore T100 (GE). Human Fab binder (GE Healthcare) was Herceptin is fused with an anti-EGFR DARPin, it can immobilized on the surface of CM5 chip (HBR-1005-30, exhibit considerable inhibitory effect on proliferation of GE) according to the manufacturer's manual. About 90-120 45 gastric cells, indicating that anti-EGFR DARPin can RU of the bispecific antibody H2E-01 was captured, and enhance the efficacy of Herceptin. various concentrations of EGFR-Fc (#344-ER, R&D Sys tems) or HER2-Fc (#1129-ER, R&D Systems) were added Example 4 to the captured bispecific antibody. 10 mMGlycine-HCl (pH 1.5) solution was added hereto, to regenerate the Surface. To so Internalization of HER2 and EGFR by the determine the affinity, the obtained data were fitted using Anti-HER2/Anti-EGFR Bispecific Antibody BIAevaluation software (GE Healthcare, Biacore T100 evaluation software). Gastric cancer cell line MKN45 (KCLB No. 80103) was The obtained results are shown in Table 1. provided at the amount of 4x10" cell?well. To the cells, TABLE 1.

U Sample Antigen Flow Cell R (RU) K (nM) k (1/Ms) k (1/s) Chi Value T(K) T(K) H2E-O1 EGFR-FC fia-ii1 78.89 0.03 1.0 x 10 <2.8 x 10 1.58 95 6.2 x 102 1.2 130522 Her2-FC #2-#1 80.45 <0.01 6.9 x 10 <7.5 x 10 1.56 95 9.8 x 102 1.4

As shown in Table 1, the bispecific antibody H2E-01 Trastuzumab (HERCEPTIN antibody, Roche), CETUX prepared in Example 1 exhibits very high affinity to EGFR 65 IMAB antibody (Erbitux, #ET509081213, Merck), and anti and HER2 as KD=0.03 nM and <0.01 nM, respectively, as HER2/anti-EGFR DARPin bispecific antibody H2E-01 pre measured by Biacore. pared in Example 1 were treated alone or in combination at US 9,499,622 B2 15 16 the amount of 1 ug/ml per each well (when treated in context. The use of the term “at least one’ followed by a list combination, each treated amount is 1 ug/ml), and incubated of one or more items (for example, “at least one of A and B) at 37° C. for 2 hours. The incubated cells were treated with is to be construed to mean one item selected from the listed 4% (v/v) formaldehyde for 15 minutes, to be immobilized on items (A or B) or any combination of two or more of the 5 listed items (A and B), unless otherwise indicated herein or plate, and then, washed three times with PBS. Thereafter, the clearly contradicted by context. The terms “comprising.” resulted cells were treated with blocking buffer (0.5% (v/v) “having,”99 “including,& and “containing are to be construed triton X-100 and 5% (v/v) donkey serum) for 1 hour at room as open-ended terms (i.e., meaning “including, but not temperature, and then, treated with primary antibodies limited to.”) unless otherwise noted. Recitation of ranges of respectively against HER2 and EGFR (primary antibody for values herein are merely intended to serve as a shorthand HER2: # 280003Z, Invitrogen, primary antibody for EGFR: 10 method of referring individually to each separate value #5616, Cell signaling) at the amount of 100 ul (1:100 falling within the range, unless otherwise indicated herein, diluted) at 4° C. for 15 hours. The resultant was washed and each separate value is incorporated into the specification three times with PBS, treated with a secondary antibody as if it were individually recited herein. All methods (#A21433, Invitrogen) at the amount of 100 ul (1:2000 described herein can be performed in any suitable order diluted) at room temperature for 1 hour, and washed again 15 unless otherwise indicated herein or otherwise clearly con three times with PBS, to prepare a plate with mounting tradicted by context. The use of any and all examples, or medium (HH-1200, Vector). The cells in the prepared plate exemplary language (e.g., “such as”) provided herein, is were observed by a confocal microscope (Zeiss, LSM710). intended merely to better illuminate the invention and does The obtained results are shown in FIG. 6. As shown in not pose a limitation on the scope of the invention unless FIG. 6, when Herceptin and Erbitux are treated in combi otherwise claimed. No language in the specification should nation, EGFR and HER2 still remain on cell membrane, be construed as indicating any non-claimed element as whereas when H2E-01 is treated, both of HER2 and EGFR essential to the practice of the invention. move into a cell. Preferred embodiments of this invention are described In conclusion, the anti-HER2/anti-EGFR DARPin bispe herein, including the best mode known to the inventors for cific antibody with an anti-EGFR DARPin inhibits EGFR 25 carrying out the invention. Variations of those preferred and HER2 is believed to act by different mechanism from embodiments may become apparent to those of ordinary that of pre-existing anti-EGFR or anti-HER2 antibody. skill in the art upon reading the foregoing description. The All references, including publications, patent applica inventors expect skilled artisans to employ such variations tions, and patents, cited herein are hereby incorporated by as appropriate, and the inventors intend for the invention to reference to the same extent as if each reference were 30 be practiced otherwise than as specifically described herein. individually and specifically indicated to be incorporated by Accordingly, this invention includes all modifications and reference and were set forth in its entirety herein. equivalents of the Subject matter recited in the claims The use of the terms “a” and “an and “the' and “at least appended hereto as permitted by applicable law. Moreover, one' and similar referents in the context of describing the any combination of the above-described elements in all invention (especially in the context of the following claims) 35 possible variations thereof is encompassed by the invention are to be construed to cover both the singular and the plural, unless otherwise indicated herein or otherwise clearly con unless otherwise indicated herein or clearly contradicted by tradicted by context.

SEQUENCE LISTING

<16 Os NUMBER OF SEO ID NOS : 17

<21 Os SEQ ID NO 1 &211s LENGTH: 153 212s. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic anti-EGFR DARPin-O1 <4 OOs SEQUENCE: 1 Asp Lieu. Gly Lys Llys Lieu. Lieu. Glu Ala Ala Arg Ala Gly Glin Asp Asp 1. 5 10 15 Glu Val Arg Ile Lieu Met Ala Asn Gly Ala Asp Val Asn Ala Asp Asp 2O 25 3O Thir Trp Gly Trp Thr Pro Leu. His Lieu Ala Ala Tyr Glin Gly His Lieu. 35 4 O 45

Glu Ile Val Glu Val Lieu. Lieu Lys Asn Gly Ala Asp Wall Asn Ala Tyr SO 55 6 O Asp Tyr Ile Gly Trp Thr Pro Lieu. His Lieu Ala Ala Asp Gly His Lieu. 65 70 7s 8O

Glu Ile Val Glu Val Lieu. Lieu Lys Asn Gly Ala Asp Wall Asn Ala Ser 85 9 O 95 Asp Tyr Ile Gly Asp Thr Pro Lieu. His Lieu Ala Ala His Asn Gly. His US 9,499,622 B2 17 - Continued

1OO 105 11 O Lieu. Glu Ile Val Glu Val Lieu. Lieu Lys His Gly Ala Asp Val Asn Ala 115 12 O 125 Glin Asp Llys Phe Gly Llys Thr Ala Phe Asp Ile Ser Ile Asp Asn Gly 13 O 135 14 O Asn Glu Asp Lieu Ala Glu Ile Lieu. Glin 145 150

<210s, SEQ ID NO 2 &211s LENGTH: 154 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic Anti-EGFR DARPin-67 <4 OOs, SEQUENCE: 2 Asp Lieu. Gly Lys Llys Lieu. Lieu. Glu Ala Ala Arg Ala Gly Glin Asp Asp 1. 5 1O 15 Glu Val Arg Ile Lieu Met Ala Asn Gly Ala Asp Val Asn Ala Thr Asp 2O 25 3 O Asn Asp Gly Asn Thr Pro Lieu. His Lieu. Ser Ala Trp Ile Gly. His Lieu 35 4 O 45 Glu Ile Val Glu Val Lieu Lleu Lys His Gly Ala Asp Wall Asn Ala Asp SO 55 60 Asp Lieu. Lieu. Gly Met Thr Pro Lieu. His Lieu Ala Ala Asp Thr Gly His 65 70 7s 8O Lieu. Glu Ile Val Glu Val Lieu Lieu Lys Tyr Gly Ala Asp Val Asn Ala 85 90 95 Arg Asp Thir Arg Gly Llys Thr Pro Lieu. His Lieu Ala Ala Arg Asp Gly 1OO 105 11 O His Lieu. Glu Ile Val Glu Val Lieu. Lieu Lys His Asp Ala Asp Wall Asn 115 12 O 125 Ala Glin Asp Llys Phe Gly Llys Thr Ala Phe Asp Ile Ser Ile Asp Asn 13 O 135 14 O Gly Asn. Glu Asp Lieu Ala Glu Ile Lieu. Glin 145 150

<210s, SEQ ID NO 3 &211s LENGTH: 154 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic Anti-EGFR DARPin- 68 <4 OOs, SEQUENCE: 3 Asp Lieu. Gly Lys Llys Lieu. Lieu. Glu Ala Ala Arg Ala Gly Glin Asp Asp 1. 5 1O 15 Glu Val Arg Ile Lieu Met Ala Asn Gly Ala Asp Val Asn Ala Phe Asp 2O 25 3 O Tyr Trp Gly Met Thr Pro Lieu. His Lieu Ala Ala Asp Asn Gly His Lieu. 35 4 O 45 Glu Ile Val Glu Val Lieu Lleu Lys His Gly Ala Asp Wall Asn Ala Ser SO 55 60 Asp Asin Phe Gly Phe Thr Pro Leu. His Leu Ala Ala Phe Tyr Gly His 65 70 7s 8O Lieu. Glu Ile Val Glu Val Lieu. Lieu Lys His Gly Ala Asp Val Asn Ala 85 90 95 US 9,499,622 B2 19 20 - Continued

Phe Asp Met Trp Gly Asn Thir Pro Lieu. His Lieu Ala Ala Glin Asn Gly 1OO 105 11 O

His Luell Glu Ile Wall Glu Wall Luell Lieu Lys Asn Gly Ala Asp Wall Asn 115 12 O 125

Ala Glin Asp Llys Phe Gly Lys Thir Ala Phe Asp Ile Ser Ile Asp Asn 13 O 135 14 O

Gly Asn Glu Asp Lieu. Ala Glu Ile Luell Glin 145 150

SEQ ID NO 4 LENGTH: 1.87 TYPE : PRT ORGANISM: Artificial Sequence FEATURE: OTHER INFORMATION: Synthetic Anti-EGFR DARPin-69

<4 OOs, SEQUENCE: 4

Asp Lieu. Gly Llys Llys Lell Lell Glu Ala Ala Arg Ala Gly Glin Asp Asp 1. 5 15

Glu Wall Arg Ile Lieu. Met Ala Asn Gly Ala Asp Wall Asn Ala Asp Asp 2O 25 3 O

Asn Ala Gly Arg Thr Pro Lell His Luell Ala Ala Asn Phe Gly His Lieu. 35 4 O 45

Glu Ile Wall Glu Wall Lell Lell Asn Gly Ala Asp Wall Asn Ala Lys SO 55 60

Gly His His Cys Asn Thir Pro Lel His Luell Ala Ala Trp Ala Gly His 65 70

Lell Glu Ile Wall Glu Wall Lell Lel Tyr Gly Ala Asp Wall Asn Ala 85 90 95

Asp Asp Asp Glu Gly Thir Lel His Luell Ala Ala Asp Ile Gly 1OO 105 11 O

Asp Luell Glu Ile Wall Glu Wall Lel Lel Tyr Gly Ala Asp Wall Asn 115 12 O 125

Ala Trp Asp Met Tyr Gly Arg Thir Luell His Lell Ala Ala Ser Ala 13 O 135 14 O

Gly His Luell Glu Ile Wall Glu Wall Lel Luell Lys Gly Ala Asp Wall 145 150 155 160

Asn Ala Glin Asp Llys Phe Gly Thir Ala Phe Asp Ile Ser Ile Asp 1.65 17s

Asn Gly Asn Glu Asp Lell Ala Glu Ile Luell Glin 18O 185

SEO ID NO 5 LENGTH: 120 TYPE : PRT ORGANISM: Artificial Sequence FEATURE: OTHER INFORMATION: Synthetic heavy chain variable region of anti-HER2 antibody

<4 OOs, SEQUENCE: 5

Glu Wall Glin Lieu Wall Glu Ser Gly Gly Gly Lieu. Wall Glin Pro Gly Gly 1. 5 15

Ser Luell Arg Luell Ser Ala Ala Ser Gly Phe Asn Ile Lys Asp Thr 2O 25 3 O

Tyr Ile His Trp Val Arg Glin Ala Pro Gly Lys Gly Lell Glu Trp Val 35 4 O 45

Ala Arg Ile Tyr Pro Thir Asn Gly Tyr Thr Arg Tyr Ala Asp Ser Wall US 9,499,622 B2 21 - Continued

SO 55 60 Lys Gly Arg Phe Thir Ile Ser Ala Asp Thir Ser Lys Asn. Thir Ala Tyr 65 70 7s 8O Lieu. Glin Met Asn. Ser Lieu. Arg Ala Glu Asp Thr Ala Val Tyr Tyr Cys 85 90 95 Ser Arg Trp Gly Gly Asp Gly Phe Tyr Ala Met Asp Tyr Trp Gly Glin 1OO 105 11 O Gly Thr Lieu Val Thr Val Ser Ser 115 12 O

<210s, SEQ ID NO 6 &211s LENGTH: 108 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic light chain variable region of anti-HER2 antibody

<4 OOs, SEQUENCE: 6 Asp Ile Gln Met Thr Glin Ser Pro Ser Ser Leu Ser Ala Ser Val Gly 1. 5 1O 15 Asp Arg Val Thir Ile Thr Cys Arg Ala Ser Glin Asp Wall Asn. Thir Ala 2O 25 3 O Val Ala Trp Tyr Glin Gln Llys Pro Gly Lys Ala Pro Llys Lieu. Lieu. Ile 35 4 O 45 Tyr Ser Ala Ser Phe Lieu. Tyr Ser Gly Val Pro Ser Arg Phe Ser Gly SO 55 60 Ser Arg Ser Gly Thr Asp Phe Thr Lieu. Thir Ile Ser Ser Leu Gln Pro 65 70 7s 8O Glu Asp Phe Ala Thr Tyr Tyr Cys Glin Glin His Tyr Thr Thr Pro Pro 85 90 95 Thr Phe Gly Glin Gly Thr Lys Val Glu Ile Lys Arg 1OO 105

<210s, SEQ ID NO 7 &211s LENGTH: 220 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic Heavy chain variable region of Trastuzumab

<4 OO > SEQUENCE: 7 Glu Val Glin Lieu Val Glu Ser Gly Gly Gly Lieu Val Glin Pro Gly Gly 1. 5 1O 15 Ser Lieu. Arg Lieu. Ser Cys Ala Ala Ser Gly Phe Asn. Ile Lys Asp Thr 2O 25 3 O Tyr Ile His Trp Val Arg Glin Ala Pro Gly Lys Gly Lieu. Glu Trp Val 35 4 O 45

Ala Arg Ile Tyr Pro Thr Asn Gly Tyr Thr Arg Tyr Ala Asp Ser Val SO 55 60

Lys Gly Arg Phe Thir Ile Ser Ala Asp Thir Ser Lys Asn. Thir Ala Tyr 65 70 7s 8O

Lieu. Glin Met Asn. Ser Lieu. Arg Ala Glu Asp Thr Ala Val Tyr Tyr Cys 85 90 95

Ser Arg Trp Gly Gly Asp Gly Phe Tyr Ala Met Asp Tyr Trp Gly Glin 1OO 105 11 O

Gly Thr Lieu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val US 9,499,622 B2 23 24 - Continued

115 12 O 125 Phe Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala Ala 13 O 135 14 O Lieu. Gly Cys Lieu Val Lys Asp Tyr Phe Pro Glu Pro Val Thr Val Ser 145 150 155 160 Trp Asn Ser Gly Ala Lieu. Thir Ser Gly Val His Thr Phe Pro Ala Val 1.65 17O 17s Lieu. Glin Ser Ser Gly Lieu. Tyr Ser Leu Ser Ser Val Val Thr Val Pro 18O 185 19 O Ser Ser Ser Leu Gly Thr Glin Thr Tyr Ile Cys Asn Val Asn His Lys 195 2OO 2O5 Pro Ser Asn. Thir Lys Val Asp Llys Llys Val Glu Pro 21 O 215 22O

<210s, SEQ ID NO 8 &211s LENGTH: 214 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic Light chain variable region of Trastuzumab

<4 OOs, SEQUENCE: 8 Asp Ile Gln Met Thr Glin Ser Pro Ser Ser Leu Ser Ala Ser Val Gly 1. 5 1O 15 Asp Arg Val Thir Ile Thr Cys Arg Ala Ser Glin Asp Wall Asn. Thir Ala 2O 25 3 O Val Ala Trp Tyr Glin Gln Llys Pro Gly Lys Ala Pro Llys Lieu. Lieu. Ile 35 4 O 45 Tyr Ser Ala Ser Phe Lieu. Tyr Ser Gly Val Pro Ser Arg Phe Ser Gly SO 55 60 Ser Arg Ser Gly Thr Asp Phe Thr Lieu. Thir Ile Ser Ser Leu Gln Pro 65 70 7s 8O Glu Asp Phe Ala Thr Tyr Tyr Cys Glin Glin His Tyr Thr Thr Pro Pro 85 90 95 Thr Phe Gly Glin Gly Thr Lys Val Glu Ile Lys Arg Thr Val Ala Ala 1OO 105 11 O Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu Lys Ser Gly 115 12 O 125 Thir Ala Ser Val Val Cys Lieu. Lieu. Asn. Asn. Phe Tyr Pro Arg Glu Ala 13 O 135 14 O Llys Val Glin Trp Llys Val Asp Asn Ala Lieu. Glin Ser Gly Asn. Ser Glin 145 150 155 160 Glu Ser Val Thr Glu Glin Asp Ser Lys Asp Ser Thr Tyr Ser Leu Ser 1.65 17O 17s Ser Thr Lieu. Thir Lieu. Ser Lys Ala Asp Tyr Glu Lys His Llys Val Tyr 18O 185 19 O Ala Cys Glu Val Thr His Glin Gly Lieu Ser Ser Pro Val Thr Lys Ser 195 2OO 2O5

Phe Asn Arg Gly Glu. Cys 21 O

<210s, SEQ ID NO 9 &211s LENGTH: 448 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: US 9,499,622 B2 25 26 - Continued <223> OTHER INFORMATION: Synthetic Heavy chain of Pertuzumab <4 OOs, SEQUENCE: 9 Glu Val Glin Lieu Val Glu Ser Gly Gly Gly Lieu Val Glin Pro Gly Gly 1. 5 1O 15 Ser Lieu. Arg Lieu Ser Cys Ala Ala Ser Gly Phe Thr Phe Thr Asp Tyr 2O 25 3 O Thir Met Asp Trp Val Arg Glin Ala Pro Gly Lys Gly Lieu. Glu Trp Val 35 4 O 45 Ala Asp Val Asn Pro Asn. Ser Gly Gly Ser Ile Tyr Asn. Glin Arg Phe SO 55 60 Lys Gly Arg Phe Thr Lieu. Ser Val Asp Arg Ser Lys Asn. Thir Lieu. Tyr 65 70 7s 8O Lieu. Glin Met Asn. Ser Lieu. Arg Ala Glu Asp Thr Ala Val Tyr Tyr Cys 85 90 95 Ala Arg Asn Lieu. Gly Pro Ser Phe Tyr Phe Asp Tyr Trp Gly Glin Gly 1OO 105 11 O Thr Lieu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe 115 12 O 125 Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala Ala Leu 13 O 135 14 O Gly Cys Lieu Val Lys Asp Tyr Phe Pro Glu Pro Val Thr Val Ser Trp 145 150 155 160 Asn Ser Gly Ala Lieu. Thir Ser Gly Val His Thr Phe Pro Ala Val Lieu. 1.65 17O 17s Gln Ser Ser Gly Lieu. Tyr Ser Leu Ser Ser Val Val Thr Val Pro Ser 18O 185 19 O Ser Ser Leu Gly Thr Glin Thr Tyr Ile Cys Asn Val Asn His Llys Pro 195 2OO 2O5 Ser Asn. Thir Lys Val Asp Llys Llys Val Glu Pro Llys Ser Cys Asp Llys 21 O 215 22O Thr His Thr Cys Pro Pro Cys Pro Ala Pro Glu Lieu. Leu Gly Gly Pro 225 23 O 235 24 O Ser Val Phe Leu Phe Pro Pro Llys Pro Lys Asp Thr Lieu Met Ile Ser 245 250 255 Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser His Glu Asp 26 O 265 27 O Pro Glu Val Llys Phe Asn Trp Tyr Val Asp Gly Val Glu Val His Asn 27s 28O 285 Ala Lys Thir Lys Pro Arg Glu Glu Glin Tyr Asn. Ser Thr Tyr Arg Val 29 O 295 3 OO Val Ser Val Lieu. Thr Val Lieu. His Glin Asp Trp Lieu. Asn Gly Lys Glu 3. OS 310 315 32O Tyr Lys Cys Llys Val Ser Asn Lys Ala Lieu Pro Ala Pro Ile Glu Lys 3.25 330 335

Thir Ile Ser Lys Ala Lys Gly Glin Pro Arg Glu Pro Glin Val Tyr Thr 34 O 345 35. O

Lieu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Glin Val Ser Lieu. Thr 355 360 365

Cys Lieu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu Trp Glu 37 O 375 38O

Ser Asn Gly Glin Pro Glu Asn Asn Tyr Lys Thr Thr Pro Pro Val Lieu. 385 390 395 4 OO US 9,499,622 B2 27 28 - Continued Asp Ser Asp Gly Ser Phe Phe Lieu. Tyr Ser Lys Lieu. Thr Val Asp Llys 4 OS 41O 415 Ser Arg Trp Glin Glin Gly Asn Val Phe Ser Cys Ser Val Met His Glu 42O 425 43 O Ala Lieu. His Asn His Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 44 O 445

<210s, SEQ ID NO 10 &211s LENGTH: 214 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic Light chain of Pertuzumab <4 OOs, SEQUENCE: 10 Asp Ile Gln Met Thr Glin Ser Pro Ser Ser Leu Ser Ala Ser Val Gly 1. 5 1O 15 Asp Arg Val Thir Ile Thr Cys Lys Ala Ser Glin Asp Wal Ser Ile Gly 2O 25 3 O Val Ala Trp Tyr Glin Gln Llys Pro Gly Lys Ala Pro Llys Lieu. Lieu. Ile 35 4 O 45 Tyr Ser Ala Ser Tyr Arg Tyr Thr Gly Val Pro Ser Arg Phe Ser Gly SO 55 60

Ser Gly Ser Gly Thr Asp Phe Thr Lieu. Thir Ile Ser Ser Leu Gln Pro 65 70 7s 8O

Glu Asp Phe Ala Thr Tyr Tyr Cys Glin Glin Tyr Tyr Ile Tyr Pro Tyr 85 90 95

Thr Phe Gly Glin Gly Thr Lys Val Glu Ile Lys Arg Thr Val Ala Ala 1OO 105 11 O

Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu Lys Ser Gly 115 12 O 125

Thir Ala Ser Val Val Cys Lieu. Lieu. Asn. Asn. Phe Tyr Pro Arg Glu Ala 13 O 135 14 O

Llys Val Glin Trp Llys Val Asp Asn Ala Lieu. Glin Ser Gly Asn. Ser Glin 145 150 155 160

Glu Ser Val Thr Glu Glin Asp Ser Lys Asp Ser Thr Tyr Ser Leu Ser 1.65 17O 17s Ser Thr Lieu. Thir Lieu. Ser Lys Ala Asp Tyr Glu Lys His Llys Val Tyr 18O 185 19 O

Ala Cys Glu Val Thr His Glin Gly Lieu Ser Ser Pro Val Thr Lys Ser 195 2OO 2O5

Phe Asn Arg Gly Glu. Cys 21 O

<210s, SEQ ID NO 11 &211s LENGTH: 13 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic modified hinge region (U7-HC6)

<4 OOs, SEQUENCE: 11 Glu Pro Ser Cys Asp Llys His Cys Cys Pro Pro Cys Pro 1. 5 1O

<210s, SEQ ID NO 12 &211s LENGTH: 13 US 9,499,622 B2 29 30 - Continued

212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic modified hinge region (U6-HC7) <4 OOs, SEQUENCE: 12 Glu Pro Llys Ser Cys Asp Cys His Cys Pro Pro Cys Pro 1. 5 1O

<210s, SEQ ID NO 13 &211s LENGTH: 12 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic modified hinge region (U3 -HC9)

<4 OOs, SEQUENCE: 13 Glu Arg Lys Cys Cys Val Glu. Cys Pro Pro Cys Pro 1. 5 1O

<210s, SEQ ID NO 14 &211s LENGTH: 14 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic modified hinge region (U6-HC8)

<4 OOs, SEQUENCE: 14 Glu Pro Arg Asp Cys Gly Cys Llys Pro Cys Pro Pro Cys Pro 1. 5 1O

<210s, SEQ ID NO 15 &211s LENGTH: 13 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic modified hinge region (U8-HC5

<4 OOs, SEQUENCE: 15 Glu Lys Cys Asp Llys Thr His Thr Cys Pro Pro Cys Pro 1. 5 1O

<210s, SEQ ID NO 16 &211s LENGTH: 15 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic human hinge region

<4 OOs, SEQUENCE: 16 Glu Pro Llys Ser Cys Asp Llys Thr His Thr Cys Pro Pro Cys Pro 1. 5 1O 15

<210s, SEQ ID NO 17 &211s LENGTH: 10 212. TYPE: PRT <213> ORGANISM: Artificial Sequence 22 Os. FEATURE: <223> OTHER INFORMATION: Synthetic

<4 OOs, SEQUENCE: 17 Gly Gly Gly Gly Ser Gly Gly Gly Gly Ser 1. 5 1O US 9,499,622 B2 31 32 What is claimed is: (2) a schv-Fc antibody comprising an antigen-binding 1. An anti-EGFR/anti-HER2 bispecific antibody compris fragment of trastuzumab, pertuzumab, trastuzumab 19. emtansine, or an anti-HER2 IgG antibody comprising a an anti-EGFR DARPin, and heavy chain variable region comprising the amino acid an anti-HER2 antibody, wherein the anti-HER2 antibody is an IgG antibody or an scFv-Fc antibody, or a sequence of SEQID NO: 5 and a light chain variable combination thereof. region comprising the amino acid sequence of SEQID 2. The bispecific antibody of claim 1, wherein the anti NO: 6. EGFR DARPin comprises at least one of SEQ ID NO: 1, 9. A method of enhancing the efficacy of an anti-HER2 SEQ ID NO: 2, SEQ ID NO: 3, or SEQ ID NO: 4, and antibody, comprising binding an anti-EGFR DARPinto an wherein at least one EGFR DARPin is, optionally, repeated 10 anti-HER2 antibody, wherein the anti-HER2 antibody is an 2 to 10 times. IgG antibody, an scFV-Fc antibody, or a combination 3. The bispecific antibody of claim 1, wherein the anti thereof. HER2 antibody is 10. The method of claim 9, wherein the anti-EGFR (1) trastuzumab, pertuzumab, trastuzumab emtansine, or DARPin comprises at least one of SEQID NO: 1, SEQ ID an anti-HER2 IgG antibody comprising a heavy chain 15 NO: 2, SEQ ID NO:3, and SEQID NO: 4, and wherein at variable region comprising SEQID NO: 5 and a light least one DARPin is, optionally, repeated 2 to 10 times. chain variable region comprising SEQ ID NO: 6; or 11. The method of claim 9, wherein the anti-HER2 (2) an scFV-Fc antibody comprising an antigen-binding antibody is fragment of trastuzumab, pertuzumab, trastuzumab (1) trastuzumab, pertuzumab, trastuzumab emtansine, or emtansine, or an anti-HER2 IgG antibody comprising a an anti-HER2 IgG antibody comprising a heavy chain heavy chain variable region comprising SEQID NO: 5 variable region comprising SEQ ID NO: 5 and a light and a light chain variable region comprising SEQ ID chain variable region comprising SEQ ID NO: 6; or NO: 6. (2) a schv-Fc antibody comprising an antigen-binding 4. A pharmaceutical composition comprising the anti fragment of trastuzumab, pertuzumab, trastuzumab 25 emtansine, or an anti-HER2 IgG antibody comprising a EGFR/anti-HER2 bispecific antibody of claim 1. heavy chain variable region comprising SEQID NO: 5 5. A method of treating a cancer in a subject, comprising and a light chain variable region comprising SEQ ID administering the anti-EGFR/anti-HER2 bispecificantibody NO: 6. of claim 1 to the subject, wherein the cancer is characterized 12. A nucleic acid encoding the bispecific antibody of by the expression of EGFR and HER2. 30 6. A method of preparing an anti-EGFR/anti-HER2 bispe claim 1, optionally in a vector. cific antibody of claim 1, comprising linking 13. A cell comprising the nucleic acid of claim 12. an anti-EGFR DARPin, and 14. A method of preparing a bispecific antibody of claim an anti-HER2 antibody, wherein the anti-HER2 antibody 1 comprising expressing a nucleic acid encoding the bispe is an IgG antibody, a scFv-Fc antibody, or a combina cific antibody in a cell. 35 15. The method of claim 5, wherein the subject is a cancer tion thereof. patient having resistance against an EGFR antagonist. 7. The method of claim 6, wherein the anti-EGFR DAR 16. The method of claim 5, wherein the subject is a cancer Pin comprises at least one of SEQ ID NO: 1, SEQ ID NO: patient having resistance against an anti-HER2 antibody. 2, SEQID NO:3, or SEQID NO: 4, and wherein at least one 17. The method of claim 5, wherein the subject is a cancer EGFR DARPin is, optionally, repeated 2 to 10 times. 40 8. The method of claim 6, wherein the anti-HER2 anti patient having resistance against an EGFR antagonist and an body is anti-HER2 antibody. (1) trastuzumab, pertuzumab, trastuzumab emtansine, or 18. The antibody of claim 1, wherein treatment of a an anti-HER2 IgG antibody comprising a heavy chain gastric cancer cell with the antibody causes internalization Variable region comprising the amino acid sequence of of HER2 and EGFR. SEQ ID NO: 5 and a light chain variable region 19. The method of claim 5, wherein the antibody causes comprising the amino acid sequence of SEQID NO: 6: internalization of HER2 and EGFR. Or ck ck ck ck *k