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ResearchIn-Press PreviewClinical ResearchOncology Open Access | 10.1172/JCI201090

EGFR- and HER3-targeted bispecific antibody-drug conjugate demonstrates anti-tumor activity in metastatic castration-resistant prostate cancer

Bangwei Fang,1 Xiaomeng Li,1 Ying Lu,2 Weiwei Ma,1 Hualei Gan,3 Tingwei Zhang,1 Qi Liu,2 Beihe Wang,1 Zixian Wang,2 Yi Zhu,4 Hai Zhu,4 Sa Xiao,5 Xiaojie Bian,1 Gonghong Wei,2 Dingwei Ye,1 and Yao Zhu1

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Fang, B. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Li, X. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Lu, Y. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Ma, W. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Gan, H. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Zhang, T. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Liu, Q. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Wang, B. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Wang, Z. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Zhu, Y. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Zhu, H. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Xiao, S. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Bian, X. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Wei, G. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Ye, D. in: PubMed | Google Scholar

1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Biochemistry and Molecular Biology of School of Basic Medical, Shanghai Medical College of Fudan University, Shanghai, China

3Department of Oncology, Fudan University, Shanghai, China

4Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu, China

5Baili-Bio (Chengdu) Pharmaceutical Co., Ltd., Chengdu, China

Find articles by Zhu, Y. in: PubMed | Google Scholar

Published April 7, 2026 - More info

J Clin Invest. https://doi.org/10.1172/JCI201090.
Copyright © 2026, Fang et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published April 7, 2026 - Version history
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Abstract

Metastatic castration-resistant prostate cancer (mCRPC) remains lethal with limited treatment options. Antibody–drug conjugates (ADCs) have emerged as a transformative class across multiple solid tumors, yet their clinical application in prostate cancer has been limited. Izalontamab brengitecan (Iza-bren; BL-B01D1) is a bispecific ADC targeting EGFR and HER3 that has demonstrated activity in other malignancies. Here, we evaluated its therapeutic potential in prostate cancer. Multi-omics analyses revealed frequent EGFR and HER3 expression in CRPC adenocarcinoma but not in neuroendocrine subtypes. BL-B01D1 exerted potent, target-dependent cytotoxicity in prostate cancer cell lines, xenografts, and patient-derived organoids (PDOs). We highlight a representative mCRPC patient with high EGFR/HER3 expression who achieved a rapid and durable clinical and radiologic response to BL-B01D1, concordant with matched PDO sensitivity. Mechanistic studies identified ABCG2 upregulation as a driver of acquired resistance, with genetic or pharmacologic inhibition restoring BL-B01D1 sensitivity. Importantly, tumor tissue obtained at progression after BL-B01D1 treatment confirmed ABCG2 upregulation, validating a clinically relevant resistance mechanism. These findings support BL-B01D1 as a promising therapeutic strategy in mCRPC and nominate ABCG2 as a rational target for overcoming resistance.

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