AbstractImmune checkpoint inhibitors (ICIs) have been making innovative advances in current cancer therapy. In particular, the PD-L1/PD-1 blockades changed the paradigm of anti-cancer treatment, showing high efficiency compared to conventional therapy. However, drug resistance has been observed in many patients receiving PD-1/PD-L1 monoclonal antibodies (mAbs), and there are still many limitations in restoring T cell. To overcome this, various ICI targets including T cell immunoreceptor with Ig and ITIM domain (TIGIT) are being studied. TIGIT is a T cell co-inhibitory receptor, highly expressed on regulatory T (Treg) cells and memory T cells and natural killer (NK) cells. In combination with PD-1/PD-L1 inhibition, the activation of CD226 through the blocking of TIGIT/PVR ligation is important for T cell activation. In this study, we demonstrated the synergistic effect that can be obtained by simultaneously blocking of PD-L1 and TIGIT and effect of T cell engager function using TIGITxPD-L1 bispecific antibody (BsAb). We generated an anti-TIGITxPD-L1 BsAb, YH41723 (IMC-202), with Fc-engineering to enhance the effector function. In order to confirm superior efficacy of YH41723 compared to combination of two monoclonal antibodies, PD-L1 mAb+TIGIT mAb, we verified the CD8+ T cell-mediated tumor killing effect by T cell engager function of YH41723. We also observed strong antibody-dependent cell-mediated cytotoxicity (ADCC) effect of YH41723 against various cancer cell lines. In addition, YH41723 showed superior anti-tumor efficacy than combination treatment in NK cell-mediated tumor killing assay. We further confirmed the significant Treg cell depletion efficacy of YH41723 in vitro compared to combination. We tested in vivo anti-cancer efficacy of YH41723 in hPD-L1 KI CT26 with BALB/c-H/K-dKO mouse models (B cell-deficient mice). As a result, YH41723 showed superior tumor growth inhibition effect compared with anti-PD-L1 mAb and anti-TIGIT mAb combination. Even, 7 of 8 mice showed complete regression in 30 mg/kg dosing group. 60 days after the last administration, we further performed tumor re-challenge test. The tumor-free state of tumor re-challenged mice was sustained, indicating that the immune memory was generated by YH41723. Taken together, YH41723 showed strong efficacy in NK/T cell activation and Treg depletion in vitro and excellent anti-tumor efficacy in vivo, supporting that YH41723 as an effective anti-cancer immunotherapy and combination candidate with other ICIs.Citation Format: Min Hyeok Jee, Young Bong Park, Byeong-Yun An, Hee Ra Jung, Eunjung Lee, Jun Hwan Kim, Ji Eun Park, Ji Young Yoon, Seung Mi Jeong, Yang Kyun Ryu, Sung Ho Kim, Heung Tae Kim, Se-Woong Oh, Yeol Hong Kim. YH41723 (IMC-202), a Novel TIGITxPD-L1 bispecific antibody, leads to potent anti-tumor immunity through T cell engaging and T/NK cell activation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2358.