Binding molecules that inhibit cancer growth

Abstract

1004870755 Abstract The invention provides means and methods for inhibiting growth of a cancer. The means in some embodiments comprise proteins and antibodies that binds an extracellular part of a membrane associated member of the epidermal growth factor (EGF) receptor family and an extracellular part of a membrane associated member of a WNT signaling pathway. Further provided are various cells and assays that are helpful in the production of the proteins, antibodies and cells. 20 23 22 29 28 3 1 A ug 2 02 3 Abstract2023222928 31 Aug 2023 1004870755

Description

This application is a divisional application of Australian application no. 5   2016340764, the entire contents of which is incorporated herein by reference. The invention relates to the field of binding molecules. In particular it relates to the field of therapeutic binding molecules for the treatment of diseases involving aberrant cells. More in particular it relates to binding molecules that bind an 10 extracellular part of a membrane associated member of the epidermal growth factor (EGF) receptor family and an extra-cellular part of a membrane associated member of a WNT signaling pathway. Cancer is still a major cause of death in the world, in spite of the many 15 advances that have been made in the treatment of the disease and the increased knowledge of the molecular events that lead to cancer. Colorectal cancer (CRC), for instance, is the third most common cancer worldwide. In 2008, 1.23 million people were diagnosed with the disease. It is the second most common cancer in Europe, with around 447,000 new cases diagnosed in 2012 (13% of the total). Colorectal 20 cancer is the fourth most common cause of cancer death, estimated to be responsible for 608,000 (EU 148,000) deaths per annum. While some new treatments have been advanced in CRC many have failed clinical testing; metastatic CRC is still largely incurable. 25          Traditionally, most cancer drug discovery has focused on agents that block essential cell functions and kill dividing cells. However, in cases of advanced cancer, no matter how aggressively applied, even to the point where patients suffer lifethreatening side-effects from the treatment, chemotherapy rarely results in a complete cure. In most cases, the tumors in the patients stop growing or temporarily 30 shrink (referred to as remission) only to start proliferating again, some times more rapidly (referred to as relapse), and become increasingly more difficult to treat. More recently the focus of cancer drug development has moved away from broadly cytotoxic chemotherapy to targeted cytostatic therapies with less toxicity. Treatment of advanced cancer with targeted therapy that specifically inhibits signaling 2023222928 31 Aug 2023 pathway components has been validated clinically in leukemia. However, in a majority of carcinomas, targeted approaches are still proving ineffective. In colorectal cancer, over 80% of patients overexpress the receptor tyrosine kinase EGFR, but treatment with EGFR blocking therapies results in response rates of ~ 5   10% and, as with chemotherapy, these responses are not durable. While in some patients the poor response rate can be linked to activating mutations downstream of the blocking agent, there is accumulating scientific evidence that a special type of self-renewing cancer cell may explain the limited activity of cancer drugs in many situations. 10 Cancer stem cells are tumor cells that share characteristics with normal stem cells, most importantly the ability to self-renew over long periods of time and give rise to many of the cell types within a given cancer. Recent evidence suggests that while conventional chemotherapy and current targeted therapies kill differentiated 15 and differentiating cells that form the bulk of tumors, the self-renewing cancer stem cell is less sensitive to these therapeutic approaches. Therefore, Cancer stem cells, which typically form a small subpopulation of cells within the tumor, may be responsible for the regeneration of the disease after therapy and the formation of metastases. Cancer stem cells are thought to arise from adult stem cells that have 20 accumulated one or more mutations that initiate cancer development. In normal stem cells, proliferation is strictly controlled both spatially and temporally through signals transmitted in their immediate environment. In contrast, cancer stem cells proliferate and differentiate in a less controlled manner outside of the normal stem cell compartment where they are dependent on mutations in oncogenes and tumor 25 suppressor genes. Without being bound by theory it is thought that means and methods have been developed that target cancer stem cells and shut down important growth and differentiation pathways in these cells. Targeting is achieved by using proteins that 30 have a binding arm specific for a stem cell target and another binding arm that specifically blocks a growth factor receptor pathway. 2023222928 31 Aug 2023 SUMMARY OF THE INVENTION In one aspect the invention provides a protein that binds an extracellular part of a membrane associated member of the epidermal growth factor (EGF) receptor 5 family and an extracellular part of a membrane associated member of a WNT signaling pathway. The protein is preferably an antibody, preferably a bispecific antibody or a functional part, derivative and / or analogue thereof. The invention also provides a bispecific antibody or a functional part, 10 derivative and / or analogue thereof that binds an extracellular part of a membrane associated member of the epidermal growth factor (EGF) receptor family and an extra-cellular part of a membrane associated member of a WNT-signaling pathway. Also provided is a method for the treatment of an individual that has a cancer, 15 the method comprising administering a protein of the invention or a bispecific antibody of the invention to the individual in need thereof. The invention further provides a protein of the invention or a bispecific antibody of the invention, for use in the treatment of an individual that has cancer. 20 In one embodiment the cancer is an EGF-receptor ligand responsive cancer that expresses a membrane associated member of the WNT pathway. Further provided is a cell system comprising a protein of the invention or a 25 bispecific antibody of the invention, and a cell that expresses a membrane associated member of the epidermal growth factor (EGF) receptor family and that expresses a membrane associated member of the WNT pathway. The cell is preferably an EGF-receptor ligand responsive cell that expresses a membrane associated member of the WNT pathway. 30 Also provided is a method for inhibiting growth of a cell that expresses a membrane associated member of the epidermal growth factor (EGF) receptor family and that expresses a membrane associated member of the WNT pathway in a system permissive for growth of the cell, the method providing the system with a protein of 2023222928 31 Aug 2023 the invention or a bispecific antibody of the invention. The cell is preferably an EGF-receptor ligand responsive cell that expresses a membrane associated member of the WNT pathway. 5          The invention provides an antibody that comprises a variable domain that can bind an epitope on an extracellular part of LGR5 which epitope is located within amino acid residues 21-118 of SEQ ID NO: 1 depicted in figure 39 of which amino acid residues D43; G44, M46, F67, G90, and F91 are involved in binding of the antibody to the epitope. 10 The antibody is preferably an antibody wherein one or more of the amino acid residue substitutions of D43A; G44A, M46A, F67A, G90A, and F91A reduces the binding of the antibody of LGR5. 15          The invention further provides an antibody that comprises a variable domain that can bind an epitope on an extracellular part of LGR5 which epitope is located within amino acid residues 21-118 of SEQ ID NO: 1 depicted in figure 39, and wherein the binding of the antibody to LGR5 reduced by one or more of the following amino acid residue substitutions D43A; G44A, M46A, F67A, G90A, and F91A. 20 The antibody is preferably an antibody wherein interaction of the antibody with LGR5 on an LGR5-expressing cell does not inhibit the binding of Rspondin 1 (RSPO 1) to LGR5 by more than 20%. The inhibition of binding of the antibody to LGR5 is preferably measured when the antibody and the RSPO are present in a 25 molar ratio of 0,1 or less; preferably in a molar ratio of between 0,1 to 0,001, (inclusive), preferably 0,1 to 0,01 (inclusive). The invention further provides an antibody that comprises a variable domain that can bind an epitope on LGR5 that is located within amino acid residues 21-118 30 of SEQ ID NO: 1 depicted in figure 39, and wherein interaction of the antibody with LGR5 on an LGR5-expressing cell does not inhibit the binding of an RSPO to LGR5 by more than 20% when the antibody and the RSPO are present in a molar ratio of 0,1 or less; preferably in a molar ratio of between 0,1 to 0,001, (inclusive), preferably 0,1 to 0,01 (inclusive). 2023222928 31 Aug 2023 The epitope is preferably a conformational epitope. The epitope is preferably located within amino acid residues 40-95 of SEQ ID NO: 1 depicted in figure 39. The binding of the antibody to LGR5 is preferably reduced with one or more of the 5 following amino acid residue substitutions D43A; G44A, M46A, F67A, G90A, and F91A. The antibody preferably further comprises a further variable domain that can bind a further protein. The further protein is preferably a membrane protein comprising an extracellular part. The further protein is preferably a membrane associated member of the epidermal growth factor (EGF) receptor family or cMET. 10 In a particularly preferred embodiment the antibody is a bispecific antibody. The bispecific antibody preferably comprises a variable domain that can bind said epitope on an extracellular part of LGR5 and a variable domain that can bind a 15 further protein. As mentioned herein the further protein is preferably a membrane associated member of the EGFR receptor family or cMET. The variable domain that binds this further protein preferably binds an extracellular part of said further protein. 20          The invention further provides a bispecific antibody comprising a variable domain that can bind an epitope on an extracellular part of LGR5 and a variable domain that can bind a further protein, wherein the LGR5 epitope is located within amino acid residues 21-118 of SEQ ID NO: 1 depicted in figure 39 of which amino acid residues D43; G44, M46, F67, G90, and F91 are involved in binding of the 25 antibody. The binding of the variable domain to LGR5 is preferably reduced with one or more of the following amino acid residue substitutions D43A; G44A, M46A, F67A, G90A, and F91A. The further protein is preferably a membrane protein comprising an extracellular part. The further protein is preferably a membrane associated member of the EGF receptor family or cMET. 30 The binding of the (bi)specific antibody to the membrane associated member of the EGF receptor family or cMET preferably reduces ligand-induced signaling in a cell that comprises said membrane associated member of the EGF receptor family or cMET. 2023222928 31 Aug 2023 The invention further provides an antibody that comprises a variable domain that can bind an epitope on an extracellular part of LGR5 which epitope is located within amino acid residues 21-118 of SEQ ID NO: 1 depicted in figure 39 and wherein 5   the binding of the protein to LGR5 is reduced with one or more of the following amino acid residue substitutions D43A; G44A, M46A, F67A, G90A, and F91A. Without being bound by theory it is believed that M46, F67, G90, and F91 of LGR5 as depicted in figure 39, are contact residues for the variable domain, i.e. the 10 antigen-binding site of the variable domain that can bind the LGR epitope. That amino acid residue substitution D43A and G44A reduces the binding of the antibody can be due to the fact that these are contact residues, however, it is also possible that these amino acid residue substitution induce a (slight) modification of the conformation of the part of LGR that has one or more of the other contact residues 15   (i.e. at positions 46, 67, 90 or 91) and that conformation change is such that antibody binding is reduced. The epitope is characterized by the mentioned amino acid substitutions. Whether an antibody binds the same epitope can be determined in various ways. In the examples a preferred method is described. The method utilizes a CHO cells. The CHO cells express LGR5 on the cell membrane, or on alanine 20 substitution mutant, preferably a mutant comprising one or more of the substitutions M46A, F67A, G90A, or F91A. The test antibody is contacted with the CHO cells and binding of the antibody to the cells compared. A test antibody binds the epitope if it binds to LGR5 and to a lesser extent to an LGR5 with a M46A, F67A, G90A, or F91A substitution. Comparing binding with a panel of mutants each 25 comprising one alanine residue substitution is preferred. Such binding studies are well known in the art. Often the panel comprises single alanine substitution mutants covering essentially all amino acid residues. For LGR5 the panel only needs to cover the extracellular part of the protein. Expression of a particular mutant can be compromised but this is easily detected by one or more LGR5 antibodies that bind to 30 different region(s). If expression is also reduced for these control antibodies the level or folding of the protein on the membrane is compromised for this particular mutant. Binding characteristics of the test antibody to the panel readily identifies whether the test antibodies exhibits reduced binding to mutants with a M46A, F67A, G90A, or F91A substitution and thus whether the test antibody is an antibody of the 2023222928 31 Aug 2023 invention. Reduced binding to mutants with a M46A, F67A, G90A, or F91A substitution also identifies the epitope to be located within amino acid residues 21118 of SEQ ID NO: 1 depicted in figure 39, the same applies to the location within amino acid residues 40-95 of SEQ ID NO: 1 depicted in figure 39. In a preferred 5 embodiment the panel includes a D43A substitution mutant; a G44A substitution mutant of both. The antibody with the VH sequence of the VH of MF5816 exhibits reduced binding to these substitution mutants. In a preferred embodiment the interaction of RSPO 1 with LGR5 on an LGR5-10 expressing cell does not inhibit the binding of the antibody to LGR5 by more than 20%. Inhibition of binding of the antibody to LGR5 is preferably measured under conditions wherein the antibody and the RSPO 1 are present in a molar ratio from of 0,1 or less; preferably in a molar ratio of between 0,1 to 0,001, (inclusive), preferably 0,1 to 0,01 (inclusive). 15 Inhibition of binding is preferably measured when the antibody and the RSPO 1 are present in a molar ratio from of 0,1 or less, preferably in a molar ratio of between 0,1 to 0,01 (inclusive). It was found that molar ratio’s of antibody to RSPO of less than 0,001 can sometimes reduce the binding of the antibody to LGR5. 20 When herein molar ratio’s of antibody to RSPO are mentioned it is preferred that the antibody is present in amounts that result in 40%-80% of the binding achieved when saturating amounts of the antibody are present. 25 The invention further provides an antibody that comprises a variable domain that can bind an epitope on an extracellular part of human EGFR of which amino acid residues 1462; G465; K489; 1491; N493; and C499 are involved in binding of the antibody to the epitope. The antibody is preferably an antibody characterized in that the binding of the antibody to EGFR is reduced with an EGFR wherein one or 30 more of the amino acid residue substitutions selected from I462A; G465A; K489A; I491A; N493A; and C499A have been introduced. The invention further provides an antibody that comprises a variable domain that can bind an epitope on an extracellular part of human EGFR which 2023222928 31 Aug 2023 epitope is located within amino acid residues 420-480 of SEQ ID NO: 2 depicted in figure 40, and wherein the binding of the antibody to LGR5 is reduced by one or more of the following amino acid residue substitutions I462A; G465A; K489A; 1491A; N493A; and C499A. The binding of the antibody to human EGFR interferes 5 with the binding of EGF to the receptor. The epitope on EGFR is a conformational epitope. The epitope is located within amino acid residues 420-480 of SEQ ID NO: 2 depicted in figure 40, preferably within 430-480 of SEQ ID NO: 2 depicted in figure 40; preferably within 438-469 of SEQ ID NO: 2 depicted in figure 40. 10 The antibody preferably comprises a further variable domain which further variable domain can bind a further protein. The further protein is preferably a membrane protein comprising an extracellular part. The further protein is preferably a membrane associated member WNT-pathway. 15 The antibody is typically a bispecific antibody. The variable domain that binds human EGFR, is preferably a variable domain with a heavy chain variable region that comprises at least the CDR3 20 sequence of the VH of MF3755 as depicted in Figure 1 or a CDR3 sequence that differs in at most three, preferably in at most two, preferably in no more than one amino acid from a CDR3 sequence of the VH of MF3755 as depicted in Figure 1. The variable domain that binds human EGFR, is preferably a variable 25 domain with a heavy chain variable region that comprises at least the CDR1, CDR2 and CDR3 sequences of the VH of MF3755 as depicted in Figure 1; or the CDR1, CDR2 and CDR3 sequences of the VH of MF3755 as depicted in Figure 1 with at most three, preferably at most two, preferably at most one amino acid substitutions. 30 The variable domain that binds human EGFR, is preferably a variable domain with a heavy chain variable region that comprises the sequence of the VH chain of MF3755 as depicted in Figure 1; or the amino acid sequence of the VH chain of MF3755 depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 2023222928 31 Aug 2023 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect to the VH chain of MF3755. The further protein is preferably LGR4; LGR5; LGR6; RNF43 or 5 ZNRF3, preferably LGR5. The invention further provides a bispecific antibody comprising a variable domain that can bind an epitope on an extracellular part of EGFR and a variable domain that can bind a further protein, wherein the EGFR epitope is 10 located within amino acid residues 420-480 of SEQ ID NO: 2 depicted in figure 40, which amino acid residues 1462; G465; K489; 1491; N493; and C499 are involved in binding of the antibody to the epitope. The binding of the variable domain to EGFR is preferably reduced with one or more of the following amino acid residue substitutions I462A; G465A; K489A; 1491A; N493A; and C499A. The further 15 protein is preferably a membrane protein comprising an extracellular part, preferably a membrane associated member of the WNT-pathway, preferably LGR5. Without being bound by theory it is believed that the contact residues of the epitope, i.e. where the variable domain contacts the human EGFR are likely 20   1462; K489; 1491; and N493. The amino acid residues G465 and C499 are likely indirectly involved in the binding of the antibody to EGFR, probably because mutation by substitution into an alanine induces a (slight) conformational alteration of the epitope resulting in a reduced binding to the epitope. 25             It has been shown that antibodies comprising one or more variable domains that bind EGFR with the mentioned epitope have a better effectivity when used to inhibit growth of an EGFR ligand responsive cancer or cell. In the context of bispecific antibodies, an arm of the antibody comprising an EGFR binding variable domain with the mentioned epitope combines better with a variety of other 30 arms comprising variable domains that bind extra-cellular parts of other cell surface proteins. DETAILED DESCRIPTION OF THE INVENTION 2023222928 31 Aug 2023 The invention discloses a protein that binds an extracellular part of a membrane associated member of the epidermal growth factor (EGF) receptor family and an extracellular part of a membrane associated member of a WNT signaling pathway. Such a protein is further also referred to as “a protein of the invention”. 5 In a preferred embodiment the protein of the invention is an antibody (or antibody part, derivative, or analogue, as described elsewhere in the application), an antibody mimetic, a polypeptide, an aptamer or a combination thereof. These proteins or aptamers typically bind to one target. The protein of the invention binds 10 to two targets. It is to be understood that any combination of these antibodies, antibody mimetics, polypeptides and aptamers can be linked together by methods known in the art. For example, in some embodiments the protein of the invention is a conjugate or a fusion protein. For antibodies the technology of making multispecific antibodies has progressed to also include bispecific antibodies that have the 15   same overall structure as a normal mono-specific antibody but wherein the two arms of the antibody each bind a different target. An antibody mimetic is a polypeptide that, like antibodies, can specifically bind an antigen, but that is not structurally related to antibodies. Antibody mimetics 20 are usually artificial peptides or proteins with a molar mass of about 3 to 20 kDa. Common advantages over antibodies are better solubility, tissue penetration, stability towards heat and enzymes, and comparatively low production costs. Nonlimiting examples of antibody mimetics are affibody molecules (typically based on the Z domain of Protein A); affilins (typically based on Gamma-B crystalline or 25 Ubiquitin); affimers (typically based on Cystatin); affitins (typically based on Sac7d from Sulfolobus acidocaldarius); alphabodies (typically based on Triple helix coiled coil); anticalins (typically based on Lipocalins); avimers (typically based on A domains of various membrane receptors); DARPins (typically based on ankyrin repeat motif); fynomers (typically based on SH3 domain of Fyn 7); kunitz domain 30 peptides (typically based on Kunitz domains of various protease inhibitors); and monobodies (typically based on type III domain of fibronectin). Monobodies are synthetic binding proteins that are constructed using a fibronectin type III domain (FN3) as a molecular scaffold. Monobodies are simple 2023222928 31 Aug 2023 and robust alternative to antibodies for creating target-binding proteins. The term "monobody" was coined in 1998 by the Koide group who published the first paper demonstrating the monobody concept using the tenth FN3 domain of human fibronectin. 5 Monobodies and other antibody mimetics are typically generated from combinatorial libraries in which portions of the scaffold are diversified using molecular display and directed evolution technologies such as phage display, mRNA display and yeast surface display. A large number of antibody mimetics have high 10 affinity and high specificity to their respective targets. Aptamers are oligonucleotide or peptide molecules that bind to a specific target molecule. Aptamers are usually created by selecting them from a large random sequence pool, but natural aptamers also exist in riboswitches. Aptamers 15 can be used for both basic research and clinical purposes as macromolecules. As used herein, the term “conjugate” refers to two or more molecules that have been covalently joined, optionally by a linking region. For example, in some embodiments, a conjugate is a first protein or non-protein moiety joined to a second 20 protein or non-protein moiety by a linking region. For example, in some embodiments of a protein of the invention it comprises or consists of two or more antibodies that have been covalently joined. A conjugate is not limited to a first and second moiety but in some embodiments may also have a third, fourth or more moieties joined by further linking regions. As described elsewhere in this application, examples of 25 protein moieties include, but are not limited to: a polypeptide, a peptidomimetic or an antibody (or antibody part, derivative, or analogue, as described elsewhere in the application). Examples of non-protein moieties include, but are not limited to aptamers. Numerous types of linker can be used, and the linker will be selected to be appropriate according to the molecule types in the conjugate and on the desired 30 properties of the linker (length, flexibility, resistance to protease activity and other similar characteristics). Such linkers may comprise nucleotides, polypeptides, or a suitable synthetic material. For example, a linker may be a flexible peptide linker. In certain embodiments, the linker may be a cleavable linker, allowing the parts of the conjugate to be separated from each other. In other embodiments, a peptide 2023222928 31 Aug 2023 linker might be a helical linker. Various examples and kits for linking proteins and other molecules are well known in the art. As used herein, the term “fusion protein” refers to a protein that comprises two or more polypeptides or proteins that have been joined at the DNA level by recombination and are expressed together as a single 5 polypeptide. A fusion protein may also comprise a peptide linking region also encoded by the DNA and expressed together with the fusion protein. A peptide linker that is part of a fusion protein, may be designed to have particular characteristics such as flexibility, hydrophilicity, protease-resistance, cleavability etc. All these properties can be designed within the DNA sequence and methods for designing 10 linkers are well known in the art. For example, antibodies can be linked together by methods well-known in the art, and as described herein, to form bispecific or multitargeting antibodies. Furthermore, bispecific antibodies can be constructed by various methods known in the art, for example, by using technology such as BiClonics®. A bispecific monoclonal antibody (BsMAb, BsAb) typically comprises 15 binding domains of two different monoclonal antibodies and consequently binds to two different epitopes. Biclonics® molecules, but also other full length IgG bispecific antibodies have two different antigen binding specificities encoded by two different variable regions of a full length IgG molecule of a Fab of a scFv. Biclonics® can be produced by co-transfection of individual cells with genetic constructs encoding two 20 different common light chain (cLC) antibodies as detailed elsewhere herein. CH3 engineering ensures efficient hetero-dimerization and formation of essentially pure bispecific antibodies. In some embodiments, a protein of the invention suppresses signaling in a cell, group of cells, tissue or tumor by an amount that is useful for the intended purpose of the protein of the invention, for example, may reduce induction 25 of any one or more of these responses by at least 5%, 10%, 15%, 20%, 25%, 30%, 35%, preferably 40%, 45%, 50%, 55%, 60%, more preferably 70%, 80%, 85%, and most preferably 90%, 95%, 99%, or 100% compared to the signaling induced by a neutral substance or negative control as measured in an assay known in the art. 30          A protein of the invention preferably comprises an antibody or a part, derivative or analogue thereof. A protein of the invention is preferably a bispecific antibody. Antibodies typically bind their target via the so-called antigen binding site. An unmodified antigen-binding site is typically formed by and present in the variable 2023222928 31 Aug 2023 domain of the antibody. The variable domain contains said antigen-binding site. A variable domain that binds an antigen is a variable domain comprising an antigenbinding site that binds the antigen. 5         In one embodiment an antibody variable domain comprises a heavy chain variable region (VH) and a light chain variable region (VL). The antigen-binding site can be present in the combined VH / VL variable domain, or in only the VH region or only the VL region. When the antigen-binding site is present in only one of the two regions of the variable domain, the counterpart variable region can contribute to the 10 folding and / or stability of the binding variable region, but does not significantly contribute to the binding of the antigen itself. As used herein, antigen-binding refers to the typical binding capacity of an antibody to its antigen. Binding of an antibody to an antigen can be assessed in 15 various ways. One way is to incubate the antibody with the antigen (preferably cells expressing the antigen), removing unbound antibody (preferably by a wash step) and detecting bound antibody by means of a labeled antibody that binds to the bound antibody. 20          Antigen binding by an antibody is typically mediated through the complementarity determining regions (CDR) of the antibody and the specific threedimensional structure of both the antigen and the variable domain allowing these two structures to bind together with precision (an interaction similar to a lock and key), as opposed to random, non-specific sticking of proteins. As an antibody typically 25 recognizes part of an antigen called the epitope of an antigen, and as such epitope may be present in other compounds as well, antibodies according to the present invention may recognize other proteins as well, if such other compounds contain the same epitope. Hence, the term “binding” does not exclude binding of the antibodies to another protein or protein(s) that contain the same epitope. Such other protein(s) 30 is preferably not a human protein. A protein of the invention such as an antibody typically does not bind to other proteins than the specified target protein on the membrane of cells in a post-natal, preferably adult human. 2023222928 31 Aug 2023 An antibody of the invention comprising an antigen-binding site that binds to an extracellular part of one membrane associated member of the epidermal growth factor (EGF) receptor family binds to the specified member and, under 5 otherwise identical conditions, at least 100-fold lower to the extracellular part of another member of the EGF receptor family of the same species. For instance, an antibody comprising an antigen-binding site that binds to ErbB-1, binds to ErbB-1 and, under otherwise identical conditions, at least a 100-fold lower to the homologous receptors ErbB-2 (HER2), ErbB-3 (HER3) and ErbB-4 (HER4) of the same species. 10 An antibody comprising an antigen-binding site that binds to ErbB-2, binds to ErbB-2 and, under otherwise identical conditions, at least a 100-fold lower to the homologous receptors ErbB-1, ErbB-3 and ErbB-4 of the same species. An antibody comprising an antigen-binding site that binds to ErbB-3, binds to ErbB-3 and, under otherwise identical conditions, at least a 100-fold lower to the homologous receptors 15 ErbB-1, ErbB-2 and ErbB-4 of the same species. An antibody comprising an antigenbinding site that binds to ErbB-4, binds to ErbB-4 and, under otherwise identical conditions, at least a 100-fold lower to the homologous receptors ErbB-1, ErbB-2 and ErbB-3 of the same species. Of course, when an antibody is designed to bind to two or more members of the family, the binding to the two or more members can be 20 essentially the same. In the present invention it is preferred that respective antibodies each bind to only one member of a family. Considering that the ErbB-family is a family of cell surface receptors, the binding is typically assessed on cells that express the receptor(s) on their cell surface. 25          An antibody of the invention preferably interferes with the binding of a ligand for the member of the EGF receptor family. The term “interferes with binding” as used herein means that binding of the antibody to the member of the EGF receptor family competes with ligand for binding to the member of the EGF receptor family. The antibody may diminish ligand binding, displace ligand when this is already 30 bound to the member of the EGF receptor family or it may, for instance through steric hindrance, at least partially prevent that ligand can bind to the member of the EGF receptor family. 2023222928 31 Aug 2023 An EGFR (ErbBl) or HER3 (ErbB3) binding protein of the invention, preferably antibody of the invention preferably inhibits respectively EGFR ligand or HER3 ligand-induced signaling, measured as ligand-induced growth of BxPC3 cells (ATCC CRL-1687) or BxPC3-luc2 cells (Perkin Elmer 125058) or ligand-induced cell 5 death of A431 cells (ATCC CRL-1555). The mentioned EGFR or HER3 binding protein can reduce ligand induced signaling by at least 5%, 10%, 15%, 20%, 25%, 30%, 35%, preferably 40%, 45%, 50%, 55%, 60%, more preferably 70%, 80%, 85%, and most preferably 90%, 95%, 99%, or 100% compared to the ligand induced effect in the presence of a neutral substance or negative control as measured in an assay 10 known in the art. EGFR and ErbB-3 each can bind a number of ligands and stimulate growth of the mentioned BxPC3 cells or BxPC3-luc2 cells. In the presence of a ligand for one or both receptors the growth of BxPC3 or BxPC3-luc2 cells is stimulated. EGFR and / or ErbB-3 ligand-induced growth of BxPC3 cells can be measured by comparing the growth of the cells in the absence and presence of the ligand. The 15 preferred EGFR ligand for measuring EGFR ligand-induced growth of BxPC3 or BxPC3-luc2 cells is EGF. The preferred ErbB-3 ligand for measuring ErbB-3 ligand-induced growth of BxPC3 or BxPC3-luc2 cells is NRG1. The ligand-induced growth is preferably measured using saturating amounts of ligand. In a preferred embodiment EGF is used in an amount of lOOng / ml of culture medium. NRG1 is 20 preferably used in lOng / ml of culture medium. EGF and NRG1 are preferably the EGF and NRG1 of R&D systems, cat. nr. 396-HB and 236-EG as described in the examples. Determination of whether a protein or antibody of the invention inhibits signaling in bivalent format, it is preferred that the method as described herein above is performed with a monospecific monovalent or bivalent version of the protein 25 or antibody. In other words a protein or antibody that only has binding sites for the receptor of which signaling is to be determined. For an antibody it would be a bivalent monospecific antibody wherein the antigen binding variable domains consist of variable domains that bind the EGF-receptor family member. 30         An EGFR or HER3 binding protein of the invention, preferably antibody of the invention preferably inhibits respectively EGFR ligand or HER3 ligand, induced growth of BxPC3 cells (ATCC CRL-1687) or BxPC3-luc2 cells (Perkin Elmer 125058). The mentioned EGFR or HER3 binding protein can reduce ligand induced growth signaling by at least 5%, 10%, 15%, 20%, 25%, 30%, 35%, preferably 40%, 45%, 50%, 2023222928 31 Aug 2023 55%, 60%, more preferably 70%, 80%, 85%, and most preferably 90%, 95%, 99%, or 100% compared to the ligand induced growth induced by a neutral substance or negative control as measured in an assay known in the art. EGFR and ErbB-3 each can bind a number of ligands and stimulate growth of the mentioned BxPC3 cells or 5 BxPC3-luc2 cells. In the presence of a ligand for one or both receptors the growth of BxPC3 or BxPC3-luc2 cells is stimulated. EGFR and / or ErbB-3 ligand-induced growth of BxPC3 cells can be measured by comparing the growth of the cells in the absence and presence of the ligand. The preferred EGFR ligand for measuring EGFR ligand-induced growth of BxPC3 or BxPC3-luc2 cells is EGF. The preferred ErbB-3 10 ligand for measuring ErbB-3 ligand-induced growth of BxPC3 or BxPC3-luc2 cells is NRG1. The ligand-induced growth is preferably measured using saturating amounts of ligand. In a preferred embodiment EGF is used in an amount of lOOng / ml of culture medium. NRG1 is preferably used in lOng / ml of culture medium. EGF and NRG1 are preferably the EGF and NRG1 of R&D systems, cat. nr. 396-HB and 23615 EG as described in the examples. An EGF-receptor family ligand is preferably an EGFR or HER3 receptor ligand. "HER3 or ErbB-3 ligand" as used herein refers to polypeptides which bind and activate ErbB-3. Examples of ErbB-3 ligands include, but are not limited to 20 neuregulin 1 (NRG1) and neuregulin 2 (NRG2) (for review Olayioye MA et al.; EMBO J (2000) Vol 19: pp 3159-3167). The term preferably includes biologically active fragments and / or variants of a naturally occurring polypeptide. “EGFR or ErbB-1 ligand” as used herein refers to polypeptides which bind and activate EGFR. Examples of EGFR ligands include, but are not limited to EGF, TGF-a, HB-EGF, 25 amphiregulin, betacellulin and epiregulin (for review Olayioye MA et al.; EMBO J (2000) Vol 19: pp 3159-3167). The term preferably includes biologically active fragments and / or variants of a naturally occurring polypeptide. An antibody of the invention comprising an antigen-binding site that binds 30   to extracellular part of a membrane associated member of a WNT signaling pathway binds to the specified member and, under otherwise identical conditions, at least 100-fold lower to the extracellular part of another membrane associated protein that is not a member of a WNT-signaling pathway of the same species such as insulinlike growth factor 1 (IGF-1) receptor. An antibody comprising an antigen-binding 2023222928 31 Aug 2023 site that binds to LGR5, binds to LGR5 and, under otherwise identical conditions, at least a 100-fold lower to an extracellular part of an IGF-1 receptor of the same species. . An antibody comprising an antigen-binding site that binds to LGR4, binds to LGR4 and, under otherwise identical conditions, at least a 100-fold lower to IGF- 5   1 receptor of the same species. An antibody comprising an antigen-binding site that binds to RNF43, binds to RNF43 and, under otherwise identical conditions, at least a 100-fold lower to IGF-1 receptor, LGR4 or LGR5 of the same species. An antibody comprising an antigen-binding site that binds to ZNRF3, binds to ZNRF3 and, under otherwise identical conditions, at least a 100-fold lower to IGF-1 receptor or RNF43 10 of the same species. Of course, when an antibody is designed to bind to two or more members of the family, the binding to the two or more members can be essentially the same. For instance, some of the antibodies that bind LGR5 can bind LGR4 of the same species and vice versa. In a preferred embodiment an antibody of the invention that comprises an antigen-binding site that binds to extracellular part of a 15 membrane associated member of a WNT signaling pathway binds to the specified member and, under otherwise identical conditions, at least 100-fold lower to the extracellular part of another membrane associated of the family of the same species. An antibody comprising an antigen-binding site that binds to LGR5, binds to LGR5 and, under otherwise identical conditions, at least 10-fold and preferably at least 20 100-fold lower to LGR4 of the same species. An antibody comprising an antigenbinding site that binds to LGR4, binds to LGR4 and, under otherwise identical conditions, at least a 10-fold and preferably at least 100-fold lower to LGR5 of the same species In the present invention it is preferred that respective antibodies each bind to only one member of a family. Preferred members of the WNT signaling 25 pathway in the context of the present invention are LRP5, LRP6, LGR4, LGR5, LGR6, FRZ1, FRZ2, FRZ3, FRZ4, FRZ5, FRZ6, FRZ7, FRZ8, FRZ9 FRZ10, ZNRF3, RNF43, N-Cadherin, Kremenl and Kremen2, ROR2 / RYK). Considering that the members of this list are cell surface receptors, the binding is typically assessed on cells that express the receptor(s) on their cell surface. 30 The term “antibody” as used herein means a proteinaceous molecule, preferably belonging to the immunoglobulin class of proteins, containing one or more variable domains that bind an epitope on an antigen, where such domains are derived from or share sequence homology with the variable domain of an antibody. 2023222928 31 Aug 2023 Antibodies for therapeutic use are preferably as close to natural antibodies of the subject to be treated as possible (for instance human antibodies for human subjects). Antibody binding can be expressed in terms of specificity and affinity. The specificity determines which antigen or epitope thereof is specifically bound by the binding 5 domain. The affinity is a measure for the strength of binding to a particular antigen or epitope. Specific binding, is defined as binding with affinities (KD) of at least lxlOe-6 M, more preferably lxlOe-7 M, more preferably with affinities higher than lxlOe-9 M. Typically, antibodies for therapeutic applications have affinities of up to lxl0e-10 M or higher. Antibodies such as the bispecific antibodies of the present 10 invention typically comprise the constant domains (Fc part) of a natural antibody. An antibody of the invention is typically a bispecific full length antibody, preferably of the human IgG subclass. An antibody of the present invention is preferably of the human IgGl subclass. Such antibodies of the invention have good ADCC properties which can, if desired, be enhanced by techniques known in the art, have favorable 15 half-life upon in vivo administration to humans and CH3 engineering technology exists that can provide for modified heavy chains that preferentially form heterodimers over homodimers upon co-expression in clonal cells. An antibody of the invention is preferably a “full length” antibody. The term 20 ‘full length’ according to the invention is defined as comprising an essentially complete antibody, which however does not necessarily have all functions of an intact antibody. For the avoidance of doubt, a full length antibody contains two heavy and two light chains. Each chain contains constant (C) and variable (V) regions, which can be broken down into domains designated CHI, CH2, CH3, VH for the heavy 25 chain, and CL, VL for the light chain. An antibody binds to antigen via the variable domains contained in the Fab fragment portion. The antibody can interact with molecules and cells of the immune system through the constant domains, mostly through the Fc portion. 30          The terms ‘variable domain’, ‘VH / VL pair’, ‘VH / VL’ are used herein interchangeably. Full length antibodies according to the invention encompass antibodies wherein mutations may be present that provide desired characteristics or are just alternatives to the ones in the original chain. Such mutations should not be deletions of substantial portions of any of the regions. However, antibodies wherein 2023222928 31 Aug 2023 one or several amino acid residues are deleted, without essentially altering the binding characteristics of the resulting antibody are embraced within the term “full length antibody”. For instance, an IgG antibody can have 1-20 amino acid residue insertions, deletions or a combination thereof in the constant region. For instance, 5 ADCC activity of an antibody can be improved when the antibody itself has a low ADCC activity, by slightly modifying the constant region of the antibody (Junttila, T. T., K. et al. (2010). Cancer Research 70: 4481-4489). Changes are sometimes also made to improve storage or production or to remove C-terminal lysines (Engineered therapeutic antibodies with improved effector functions. Kubota T, Niwa R, Satoh 10 M, Akinaga S, Shitara K, Hanai N). Another way to improve ADCC activity of an antibody is by enzymatically interfering with the glycosylation pathway resulting in a reduced fucose (von Horsten et al. (2010); Glycobiology 20:1607-1618). Several in vitro methods exist for determining the efficacy of antibodies or effector cells in eliciting ADCC. Among these are chromium-51 [Cr51] release assays, europium [Eu] 15 release assays, and sulfur-35 [S35] release assays. Usually, a labeled target cell line expressing a certain surface-exposed antigen is incubated with antibody specific for that antigen. After washing, effector cells expressing Fc receptor CD16 are coincubated with the antibody-labeled target cells. Target cell lysis is subsequently measured by release of intracellular label by a scintillation counter or 20 spectrophotometry. A bispecific antibody of the invention can in one embodiment be afucosylated. A bispecific antibody of the invention preferably comprises a reduced amount of fucosylation of the N-linked carbohydrate structure in the Fc region, when compared 25 to the same antibody produced in a normal CHO cell. Full length IgG antibodies are preferred because of their favorable half-life and the need to stay as close to fully autologous (human) molecules for reasons of immunogenicity. An antibody of the invention is preferably a bispecific IgG antibody, 30 preferably a bispecific full length IgGl antibody. IgGl is favored based on its long circulatory half-life in man. In order to prevent any immunogenicity in humans it is preferred that the bispecific IgG antibody according to the invention is a human IgGl. 2023222928 31 Aug 2023 The term ‘bispecific’ (bs) means that one part of the antibody (as defined above) binds to one epitope on an antigen whereas a second part binds to a different epitope on either the same antigen, or a different antigen. The different epitopes are typically present on different antigens. The different epitopes can, however, also be 5 present on the same antigen. According to the present invention, said first and second antigens are in fact two different proteins. A preferred bispecific antibody is an antibody that comprises parts of two different monoclonal antibodies and consequently can bind to two different types of antigen. Dependent on the expression level, (sub-)cellular localization and stoichiometry of the two antigens recognized by 10 a bispecific antibody, both Fab arms of the antibody may or may not simultaneously bind their epitope. One arm of the bispecific antibody typically contains the variable domain of one antibody and the other arm contains the variable domain of another antibody (i.e. one arm of the bispecific antibody is formed by one heavy chain paired with one light chain whereas the other arm is formed by a different heavy chain 15   paired with a light chain). The heavy chain variable regions of the bispecific antibody of the invention are typically different from each other, whereas the light chain variable regions are preferably the same in the bispecific antibodies of the invention. A bispecific antibody wherein the different heavy chain variable regions are associated with the same or a common, light chain is also referred to as a bispecific 20 antibody with a common light chain (cLC). Further provided is therefore a bispecific antibody according to the invention, wherein both arms comprise a common light chain. Preferred bispecific antibodies can be obtained by co-expression of two 25 different heavy chains and a common light chain in a single cell. When wildtype CH3 domains are used, co-expression of two different heavy chains (A and B) and a common light chain will result in three different antibody species, AA, AB and BB. AA and BB are designations for the two mono-specific, bivalent antibodies, and AB is a designation for the bispecific antibody. To increase the percentage of the desired 30 bispecific product (AB) CH3 engineering can be employed, or in other words, one can use heavy chains with compatible hetero-dimerization domains, as defined hereunder. 2023222928 31 Aug 2023 The term ‘compatible hetero-dimerization domains’ as used herein refers to protein domains that are engineered such that engineered domain A’ will preferentially form heterodimers with engineered domain B’ and vice versa, whereas homo-dimerization between A’-A’ and B’-B’ is diminished. 5          Bispecific antibodies as described herein preferably comprise a common light chain. The term ‘common light chain’ according to the invention refers to light chains which may be identical or have some amino acid sequence differences while the binding specificity of the full length antibody is not affected. It is for instance possible within the scope of the definition of common light chains as used herein, to 10 prepare or find light chains that are not identical but still functionally equivalent, e.g., by introducing and testing conservative amino acid changes, changes of amino acids in regions that do not or only partly contribute to binding specificity when paired with the heavy chain, and the like. The terms ‘common light chain’, ‘common VL’, ‘single light chain’, ‘single VL’, with or without the addition of the term 15 ‘rearranged’ are all used herein interchangeably. It is an aspect of the present invention to use as common light chain a human light chain that can combine with different heavy chains to form antibodies with functional antigen binding domains (WO2004 / 009618, WO2009 / 157771, Merchant et al. 1998 and Nissim et al. 1994). Preferably, the common light chain has a germline sequence. A preferred germline 20 sequence is a light chain variable region that is frequently used in the human repertoire and has good thermodynamic stability, yield and solubility. A preferred germline light chain is 012, preferably the rearranged germline human kappa light chain IgVKl-39*01 / IGJKl*01 (Figure 3) or a fragment or a functional equivalent (i.e. same IgVKl-39 gene segment but different IGJk gene segment) thereof 25 (nomenclature according to the IMGT database worldwide web at imgt.org). However, the same principle also works with a lambda light chain and this is therefore also provided in the context of the invention. Further provided is therefore a bispecific antibody according to the invention, wherein said common light chain is a germline light chain, preferably a rearranged germline human kappa light chain 30 comprising the IgVKl-39 gene segment, most preferably the rearranged germline human kappa light chain IgVKl-39*01 / IGJKl*01 (Figure 3). The terms rearranged germline human kappa light chain IgVKl-39*01 / IGJKl*01, IGKV1-39 / IGkJ1, huVKl-39 light chain or in short huVKl-39, or simply 1-39 are used interchangeably throughout the application. Obviously, those of skill in the art will recognize that 2023222928 31 Aug 2023 “common” also refers to functional equivalents of the light chain of which the amino acid sequence is not identical. Many variants of said light chain exist wherein mutations (deletions, substitutions, additions) are present that do not materially influence the formation of functional binding regions. The light chain of the present 5 invention can also be a light chain as specified herein above, having 1-20, preferably 1-5 amino acid insertions, deletions, substitutions or a combination thereof. Also contemplated are antibodies wherein a VH is capable of specifically recognizing a first antigen and the VL, paired with the VH in an immunoglobulin 10 variable domain, is capable of specifically recognizing a second antigen. The resulting VH / VL pair will bind either antigen 1 or antigen 2. Such so called “two-in-one antibodies”, described in for instance WO2008 / 027236, WO2010 / 108127 and Schaefer et al (2011 Cancer Cell 20, 472-486), are different from bispecific antibodies of the invention and are further referred to as “two-in-one” antibodies. 15 A part of an antibody is an antigen binding part and typically contains the variable domains of the antibody. A part can also be a so-called single domain antibody fragment. A single-domain antibody fragment (sdAb, called Nanobody by Ablynx, the developer) is an antibody fragment with a single monomeric variable 20 antibody domain. Like a whole antibody, it is able to bind selectively to a specific antigen. With a molecular weight of only 12—15 kDa, single-domain antibody fragments are much smaller than common antibodies (150—160 kDa) which are composed of two heavy protein chains and two light chains, and even smaller than Fab fragments (~50 kDa, one light chain and half a heavy chain) and single-chain 25 variable fragments (~25 kDa, two variable domains, one from a light and one from a heavy chain). Single-domain antibodies by themselves are not much smaller than normal antibodies (being typically 90-100kDa). Single-domain antibody fragments are mostly engineered from heavy-chain antibodies found in camelids; these are called VHH fragments (Nanobodies®). Some fishes also have heavy-chain only 30 antibodies (IgNAR, 'immunoglobulin new antigen receptor'), from which singledomain antibody fragments called VNAR fragments can be obtained. An alternative approach is to split the dimeric variable domains from common immunoglobulin G (IgG) from humans or mice into monomers. Although most research into singledomain antibodies is currently based on heavy chain variable domains, nanobodies 2023222928 31 Aug 2023 derived from light chains have also been shown to bind specifically to target epitopes. A non-limiting example of an antibody part contains a variable domain of a heavy chain and / or a light chain of an antibody or an equivalent thereof. Non-limiting examples of such parts are VHH, Human Domain Antibodies (dAbs) and Unibodies. 5 Preferred antibody parts or derivatives have at least a variable domain of a heavy chain and a light chain of an antibody or equivalents thereof. Non-limiting examples of such binding molecules are F(ab)-fragments and Single chain Fv fragments. A functional part of a bispecific antibody comprises the antigen binding parts of the bispecific antibody, or a derivative and / or analogue of the binding parts. As 10 mentioned herein above, the binding part of an antibody is encompassed in the variable domain. A derivative of an antibody is a protein that but for the CDR regions deviates from the amino acid sequence of a natural antibody in at most 20 amino acids. A 15 derivative of an antibody as disclosed herein is an antibody that deviates from said amino acid sequence in at most 20 amino acids. Preferred membrane associated member of the WNT pathway that a protein of the invention binds to is LRP5, LRP6, LGR4, LGR5, LGR6, FRZ1 , FRZ2, FRZ3, 20 FRZ4, FRZ5, FRZ6, FRZ7, FRZ8, FRZ9 FRZ10, ZNRF3, RNF43, N-Cadherin, Kremenl and Kremen2, ROR2, RYK. From this list the membrane associated members of the LGR family that are active in the WNT pathway are preferred, in particular LGR4, LGR5 and LGR6. In a preferred embodiment the membrane associated member of the LGR family is LGR4 or LGR 5, in particular LGR5. Other 25 preferred membrane associated members of the canonical WNT pathway are ZNRF3 and RNF43. Mouse Lgr4, Lgr5, and Lgr6 have been demonstrated to be high affinity receptors for R-spondins (R-spondin 1-4) leading to increased phosphorylation of Wnt 30 receptors Lrp5 / 6 and stabilization of b-catenin without the involvement of G-protein signaling (Carmon, K.S., et al. (2011). Proc Natl Acad Sci USA 108, 11452-11457; de Lau, W., et al. (2011) Nature 476, 293-297.). The R-spondins are members of a much larger family of proteins characterized by the presence of thrombospondin repeats (TSRs). R-spondins also contain N-terminal cysteine-rich Furin repeats 2023222928 31 Aug 2023 which are required to exert the Wnt-enhancing activity as measured by b-catenin stabilization and phosphorylation of the Wnt / Frizzled coreceptor Lrp6 (Kim et al. (2005)). Gene fusions that increase expression levels of functional R-spondins have been reported in a subset of human colon cancers (Seshagiri, S., et al. (2012). Nature 5   488, 660-664.). While the perceived role of the Lgr-R-spondin complex is to modulate signaling through the Lrp-Frizzed-wnt receptor complex, current models suggest that the Lgr-R-spondin complex is itself subject to modulation through the highly homologous E3 ligases Rnf43 and Znrf3. Specifically, Lgr4, Lgr5, and Lgr6 receptors serve to efficiently recruit R-spondin ligands and bring these into position for 10 interaction with Rnf43 / Znrf3, which also contain R-spondin binding sites (de Lau, W., et al (2014). Genes Dev 28, 305-316). This interaction leads to membrane clearance of the Rnf43 or Znrf3, resulting in persistence of surface Frizzled receptors, and the boosting of wnt signal strength( de Lau, et al (2014). Genes Dev 28, 305-316) and enriched in colon cancer (Hao, H.-15   X., et al. (2012) Nature 485, 195-200). A membrane associated member of the WNT pathway that is active in the canonical pathway, it can also be active, depending on the particular member, in the non-canonical pathway and vice versa. 20 The human epidermal growth factor (EGF) receptor family (HER) has four members: ErbB (Erythroblastoma)-l, ErbB-2, ErbB-3 and ErbB-4. Epidermal growth factor (EGF) receptor (EGFR, ErbBl, or HER1) is a member of a family of four receptor tyrosine kinases (RTKs), named Her- or cErbB-1, -2, -3 and -4. ErbB-1 25 is also known under various synonyms, the most common of which is EGFR. EGFR has an extracellular domain (ECD) that is composed of four sub-domains, two of which are involved in ligand binding and two of which are involved in homo-dimerisation and hetero-dimerisation. EGFR integrates extracellular signals from a variety of ligands to yield diverse intracellular responses. The major signal 30 transduction pathway activated by EGFR is composed of the Ras-mitogen-activated protein kinase (MAPK) mitogenic signalling cascade. Activation of this pathway is initiated by the recruitment of Grb2 to tyrosine phosphorylated EGFR. This leads to activation of Ras through the Grb2-bound Ras-guanine nucleotide exchange factor Son of Sevenless (SOS). In addition, the PI3-kinase-Akt signal transduction pathway 2023222928 31 Aug 2023 is also activated by EGFR, although this activation is much stronger in case there is co-expression of ErbB-3 (HER3). The EGFR is implicated in several human epithelial malignancies, notably cancers of the breast, bladder, non-small cell lung cancer lung, colon, ovarian head and neck and brain. Activating mutations in the gene have been 5 found, as well as over-expression of the receptor and of its ligands, giving rise to autocrine activation loops. This RTK has therefore been extensively used as target for cancer therapy. Both small-molecule inhibitors targeting the RTK and monoclonal antibodies (mAbs) directed to the extracellular ligand-binding domains have been developed and have shown hitherto several clinical successes, albeit 10 mostly for a select group of patients. The database accession number for the human EGFR protein and the gene encoding it is (GenBank NM_005228.3). This accession number is primarily given to provide a further method of identification of EGFR protein as a target, the actual sequence of the EGFR protein bound by an antibody may vary, for instance because of a mutation in the encoding gene such as those 15 occurring in some cancers or the like. The words cancer and tumor are used herein and typically both refer to cancer, unless otherwise specifically stated. Where reference herein is made to EGFR, the reference refers to human EGFR unless otherwise stated. The antigen-binding site that binds EGFR, binds 20 EGFR and a variety of variants thereof such as those expressed on some EGFR positive tumors. The term ‘ErbB-3’ as used herein refers to the protein that in humans is encoded by the ERBB3 gene. Alternative names for the gene or protein are HER3; 25 LCCS2; MDA-BF-1; c-ErbB-3; c-ErbB3; ErbB3-S; pl80-ErbB3; p45-sErbB3; and p85-sErbB3. Where reference is made herein to ErbB-3, the reference refers to human ErbB-3. An antibody comprising an antigen-binding site that binds ErbB-3, binds human ErbB-3. The ErbB-3 antigen-binding site may, due to sequence and tertiary structure similarity between human and other mammalian orthologs, also bind such 30 an ortholog but not necessarily so. Database accession numbers for the human ErbB- 3 protein and the gene encoding it are (NP_001005915.1,NP_001973.2, NC_000012.11, NC_018923.2, NT_029419.12). The accession numbers are primarily given to provide a further method of identification of ErbB-3 as a target, the actual sequence of the ErbB-3 protein bound by an antibody may vary, for instance because 2023222928 31 Aug 2023 of a mutation in the encoding gene such as those occurring in some cancers or the like. The ErbB-3 antigen binding site binds ErbB-3 and a variety of variants thereof, such as those expressed by some ErbB-3 positive tumor cells. The antigen-binding site that binds ErbB-3 preferably binds domain III of ErbB-3. The EGF receptor 5 family member as mentioned herein as a target for the protein of the invention or the bispecific antibody of the invention is preferably epidermal growth factor receptor Erbb-1 (EGFR), ErbB-3 or ErbB-4. In a preferred embodiment the EGF receptor family member is ErbB-1 or ErbB-3. 10          The term “LGR” refers to the family of proteins known as Leucine-rich repeat containing G-protein coupled receptors. Several members of the family are known to be involved in the WNT signaling pathway, of note LGR4; LGR5 and LGR6. LGR4 is Leucine-Rich Repeat Containing G Protein-Coupled Receptor 4 Alternative names for the gene or protein are; GPR48; G    Protein-Coupled 15 Receptor 48; BNMD17; Leucine-Rich Repeat-Containing G Protein-Coupled Receptor 4; Leucine-Rich Repeat-Containing G-Protein Coupled Receptor 4; G-Protein Coupled Receptor 48; A protein or antibody of the invention that binds LGR4, binds human LGR4. 20 The LGR4 binding protein or antibody of the invention may, due to sequence and tertiary structure similarity between human and other mammalian orthologs, also bind such an ortholog but not necessarily so. Database accession numbers for the human LGR4 protein and the gene encoding it are (NC_000011.10; NC_018922.2; NT_009237.19; NP_060960.2). The accession numbers are primarily given to provide 25 a further method of identification of LGR4 as a target, the actual sequence of the LGR4 protein bound may vary, for instance because of a mutation in the encoding gene such as those occurring in some cancers or the like. The LGR4 antigen binding site binds LGR4 and a variety of variants thereof, such as those expressed by some LGR4 positive tumor cells. 30 LGR5 is Leucine-Rich Repeat Containing G Protein-Coupled Receptor 5 Alternative names for the gene or protein are Leucine-Rich Repeat Containing G Protein-Coupled Receptor 5; Leucine-Rich Repeat-Containing G Protein-Coupled Receptor 5; G-Protein Coupled Receptor HG38; G-Protein Coupled Receptor 49; G- 2023222928 31 Aug 2023 Protein Coupled Receptor 67; GPR67; GPR49; Orphan G Protein-Coupled Receptor HG38; G Protein-Coupled Receptor 49; GPR49; HG38 and FEX. A protein or antibody of the invention that binds LGR5, binds human LGR5. 5 The LGR5 binding protein or antibody of the invention may, due to sequence and tertiary structure similarity between human and other mammalian orthologs, also bind such an ortholog but not necessarily so. Database accession numbers for the human LGR5 protein and the gene encoding it are (NC_000012.12; NT_029419.13; NC_018923.2; NP_001264155.1; NP_001264156.1; NP_003658.1). The accession 10 numbers are primarily given to provide a further method of identification of LGR5 as a target, the actual sequence of the LGR5 protein bound may vary, for instance because of a mutation in the encoding gene such as those occurring in some cancers or the like. The LGR5 antigen binding site binds LGR5 and a variety of variants thereof, such as those expressed by some LGR5 positive tumor cells. 15 ZNRF3 is Zinc And Ring Finger 3. Alternative names for the gene or protein are Zinc And Ring Finger 3; Zinc / RING Finger Protein 3; RING Finger Protein 203; KIAA1133; RNF203; Novel C3HC4 Type Zinc Finger (Ring Finger); E3 Ubiquitin-Protein Ligase ZNRF3; CTA-292E10.6; EC 6.3.2.; and BK747E2.3 3. 20 A protein or antibody of the invention that binds ZNRF3, binds human ZNRF3. The ZNRF3 binding protein or antibody of the invention may, due to sequence and tertiary structure similarity between human and other mammalian orthologs, also bind such an ortholog but not necessarily so. Database accession 25 numbers for the human ZNRF3 protein and the gene encoding it are (NC_000022.11; NT_011520.13; NC_018933.2; NP_001193927.1; NP_115549.2). The accession numbers are primarily given to provide a further method of identification of ZNRF3 as a target, the actual sequence of the ZNRF3 protein bound may vary, for instance because of a mutation in the encoding gene such as those occurring in some cancers 30 or the like. The ZNRF3 antigen binding site binds ZNRF3 and a variety of variants thereof, such as those expressed by some ZNRF3 positive tumor cells. 2023222928 31 Aug 2023 RNF43 is Ring Finger Protein 43. Alternative names for the gene or protein are Ring Finger Protein 43; RNF124; E3 Ubiquitin-Protein Ligase RNF43; RING Finger Protein 43; EC 6.3.2.; URCC. A protein or antibody of the invention that binds RNF43, binds human 5 RNF43. The RNF43 binding protein or antibody of the invention may, due to sequence and tertiary structure similarity between human and other mammalian orthologs, also bind such an ortholog but not necessarily so. Database accession numbers for the human RNF43 protein and the gene encoding it are (NC_000017.11; NT_010783.16; NC_018928.2; NP_001292473.1; NP_001292474.1; NP_060233.3). 10 The accession numbers are primarily given to provide a further method of identification of RNF43 as a target, the actual sequence of the RNF43 protein bound may vary, for instance because of a mutation in the encoding gene such as those occurring in some cancers or the like. The RNF43 antigen binding site binds RNF43 and a variety of variants thereof, such as those expressed by some RNF43 positive 15 tumor cells. Insulin-like growth factor 1 (IGF-1) receptor binds insulin-like growth factor with a high affinity. The receptor has tyrosine kinase activity. The insulin-like growth factor I receptor plays a critical role in transformation events. Cleavage of 20 the precursor generates alpha and beta subunits. It is overexpressed in most malignant tissues where it functions as an anti-apoptotic agent by enhancing cell survival. The protein is known under a number of different names such as IGF-I Receptor; EC 2.7.10.1; Insulin-Like Growth Factor I Receptor; Soluble IGF1R; Variant 1; Soluble IGF1R Variant 2; CD221 Antigen; EC 2.7.10; CD221; IGFIR; 25 JTK13; and IGFR. External Ids for IGFIR are HGNC: 5465; Entrez Gene: 3480; Ensembl: ENSG00000140443; OMIM: 147370 and UniprotKB: P08069. The invention further provides a method for inhibiting growth of a cell that expresses a membrane associated member of the epidermal growth factor (EGF) 30 receptor family and that expresses a membrane associated member of the WNT pathway in a system permissive for growth of the cell, the method comprising providing the system with a protein of the invention or a bispecific antibody of the invention. The cell is preferably an EGF-receptor ligand responsive cell that expresses a membrane associated member of the WNT pathway. The system is 2023222928 31 Aug 2023 preferably a culture system. The method preferably comprises culturing said cell in said system. In the context of the present invention cell is said to express a membrane 5 associated member of the WNT pathway if the cell comprises detectable RNA that codes for the membrane associated member of the WNT pathway. Expression can often also be detected by incubating the cell with an antibody that binds to the membrane associated member of the WNT pathway. However, some members are not expressed high enough for such an antibody test or for some members, there are 10 no specific antibodies available. In such cases mRNA detection is preferred. Where herein accession numbers or alternative names of proteins / genes are given, they are primarily given to provide a further method of identification of the mentioned protein as a target, the actual sequence of the target protein bound by an 15 antibody of the invention may vary, for instance because of a mutation and / or alternative splicing in the encoding gene such as those occurring in some cancers or the like. The invention also provides a method for the treatment of an individual that 20 has a cancer, the method comprising administering a protein of the invention or a bispecific antibody of the invention to the individual in need thereof. The individual is preferably an individual that has cancer. The cancer is preferably an adenocarcinoma. Preferred cancers are Colorectal cancer; Pancreatic cancer; Lung cancer; Breast cancer; Liver cancer; Prostate cancer; Ovarian cancer; Cervical 25 cancer; Endometrial cancer; Head and Neck cancer; Melanoma; Testis cancer; Urothelial cancer; Renal cancer; Stomach cancer; or Carcinoid cancer. In a preferred embodiment the cancer is Colorectal cancer; Pancreatic cancer; Lung cancer; Breast cancer; Liver cancer; Prostate cancer; Ovarian cancer; Cervical cancer; Endometrial cancer; Head and Neck cancer; or Melanoma. In a particularly preferred embodiment 30 the cancer is Colorectal cancer; Pancreatic cancer; Lung cancer; Breast cancer; or Liver cancer. In a particularly preferred embodiment the cancer is a gastrointestinal cancer. In a preferred embodiment the cancer is Colorectal cancer. 2023222928 31 Aug 2023 The cancer is preferably, but not limited to, a cancer that exhibits a growth response when provided with an EGF receptor family member ligand. The protein of the invention is preferably a protein that binds to a EGF receptor family member for which the cancer exhibits a growth response. In a preferred embodiment the cancer 5 exhibits a growth response in vitro in response to EGF family members in the culture medium. The in vitro is preferably a culture as detailed for organoids in the experimental section. The cancer is preferably a cancer that expresses the membrane associated member of the WNT pathway that the protein of the invention binds to. 10          Further provided is a cell system comprising a protein of the invention or a bispecific antibody of the invention, and a cell that expresses a membrane associated member of the epidermal growth factor (EGF) receptor family and that expresses a membrane associated member of the WNT pathway. The cell is preferably an EGF-receptor ligand responsive cell that expresses a membrane associated member of the 15 WNT pathway. The system or cell system as described herein is preferably an in vitro culture system. The system can be used to detect growth responses of the cell. In a preferred embodiment the EGF-receptor ligand is a ligand for a preferred member of the EGF 20 receptor family as defined elsewhere herein. In a preferred embodiment the membrane associated member of the WNT pathway is a preferred membrane associated member of the WNT pathway as defined elsewhere herein. A cancer or a cell that is EGF-receptor ligand responsive exhibits a growth 25 (proliferation) response to an EGF receptor ligand. A preferred method for determining whether a cell or a cancer is EGF-receptor ligand responsive is to determine growth factor responsiveness of the cell in an organoid culture assay as described in the examples. One method is to seed the cell or cells of the cancer in the organoid cell system in the presence or absence of growth factors such as (EGF 30   (5ng / ml), or NRG (5ng / ml)) and then culture for 5 days. The number of viable cells can subsequently be determined using the Cell Titer Gio cell viability assay (Promega, cat. nr. G7571). The luminescence readout using growth factor-stimulated cells can then be compared to that obtained using non-stimulated cells (absence of the growth factor(s). 2023222928 31 Aug 2023 The invention further provides a method for inhibiting growth of a cell that expresses a membrane associated member of the EGF receptor family and that expresses a membrane associated member of the WNT pathway in a system 5 permissive for growth of the cell, the method comprising providing the system with a protein of the invention or a bispecific antibody of the invention. The cell is preferably an EGF-receptor ligand responsive cell that expresses a membrane associated member of the WNT pathway. The inhibition is preferably a decrease of at least 10% in cell number or a derivative measure for the number of cells such as 10 tumor size, when compared to the number of cells resulting under otherwise similar conditions but for the presence of the protein or the bispecific antibody of the invention. The inhibition is preferably a decrease of at least 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90% in the number of cells. The inhibition may also be a decrease of at least 10% in other parameters associated with tumour malignancy or dysplasia, 15 such as the number of lumens per organoid, when compared to the number of lumens resulting under otherwise similar conditions but for the presence of the protein or the bispecific antibody of the invention. The inhibition is preferably a decrease of at least 20%, 30%, 40%, 50%, 60%, 70%, 80% or 90% in the number of lumens per organoid. 20 For the avoidance of doubt the reference to the growth of a cell as used herein refers to a change in the number of cells. Inhibition of growth refers to a reduction in the number of cells that would otherwise have been obtained. Increase in growth refers to an increase in the number of cells that would otherwise have been obtained. 25 The growth of a cell typically refers to the proliferation of the cell. The binding of the protein or bispecific antibody of the invention to a cell comprising said membrane associated member of the epidermal growth factor (EGF) receptor family or cMET; and / or said membrane associated member of a WNT 30 signaling pathway on the membrane reduces the growth / proliferation of said cell in the presence of a growth factor for said epidermal growth factor (EGF) receptor family or cMET and / or Rspondin. The reduction is compared to the growth / proliferation of the same cell under otherwise identical conditions in the absence of the protein or bispecific antibody of the invention. 2023222928 31 Aug 2023 The protein or bispecific antibody of the invention, or functional part, derivative and / or analogue thereof is preferably selected from a protein or bispecific antibody of the invention, or functional part, derivative and / or analogue thereof that 5 binds ErbB-1 and LGR4; ErbB-1 and LGR5; ErbB-1 and LGR6; ErbB-1 and ZNRF3; ErbB-1 and RNF43; ErbB-2 and LGR4; ErbB-2 and LGR5; ErbB-2 and LGR6; ErbB-2 and ZNRF3; ErbB-2 and RNF43; ErbB-3 and LGR4; ErbB-3 and LGR5; ErbB-3 and LGR6; ErbB-3 and ZNRF3; ErbB-3 and RNF43; ErbB-4 and LGR4; ErbB-4 and LGR5; ErbB-4 and LGR6; ErbB-4 and ZNRF3; and ErbB-4 and RNF43. 10 In a preferred embodiment it is selected from ErbB-1 and LGR4; ErbB-1 and LGR5; ErbB-1 and ZNRF3; ErbB-1 and RNF43; ErbB-3 and LGR4; ErbB-3 and LGR5; ErbB-3 and ZNRF3; ErbB-3 and RNF43; ErbB-4 and LGR4; ErbB-4 and LGR5; ErbB-4 and ZNRF3; and ErbB-4 and RNF43. In a preferred embodiment it is 15 selected from ErbB-1 and LGR4; ErbB-1 and LGR5; ErbB-1 and ZNRF3; ErbB-1 and RNF43; ErbB-3 and LGR4; ErbB-3 and LGR5; ErbB-3 and ZNRF3; ErbB-3 and RNF43. Preferably it is selected from ErbB-1 and LGR5; ErbB-1 and ZNRF3; ErbB-1 and RNF43; ErbB-3 and LGR5; ErbB-3 and ZNRF3; and ErbB-3 and RNF43. In a particularly preferred embodiment the protein or bispecific antibody of the 20 invention, or functional part, derivative and / or analogue thereof is selected from a protein or bispecific antibody of the invention, or functional part, derivative and / or analogue thereof that binds ErbB-1 and LGR5; and ErbB-3 and LGR5. The antibody or bispecific antibody preferably comprises two variable 25 domains wherein one variable domain binds an extracellular part of one protein and the other variable domain binds an extracellular part of the other protein. In one embodiment the invention provides a bispecific antibody comprising a variable domain that binds ErbB-1, wherein a heavy chain variable region of said 30 variable domain comprises at least the CDR3 sequence of an ErbB-1 specific heavy chain variable region selected from the group consisting of MF3370; MF3755; MF4280 or MF4289 as depicted in Figure 1 or wherein a heavy chain variable region of said variable domain comprises a heavy chain CDR3 sequence that differs in at most three, preferably in at most two, preferably in no more than one amino acid 2023222928 31 Aug 2023 from a CDR3 sequence of a VH selected from the group consisting of MF3370; MF3755; MF4280 or MF4289 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR3 sequence of MF3370; MF3755; MF4280 or MF4289 as depicted in Figure 1. 5          Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of an ErbB-1 specific heavy chain variable region selected from the group consisting of MF3370; MF3755; MF4280 or MF4289 as depicted in Figure 1, or heavy chain CDR1, CDR2 and CDR3 sequences that differ in at most three, preferably in at most two, preferably in at 10 most one amino acid from the CDR1, CDR2 and CDR3 sequences of ErbB-1 specific heavy chain variable region selected from the group consisting of MF3370; MF3755; MF4280 or MF4289 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of MF3370; MF3755; MF4280 or MF4289 as depicted in Figure 1. 15 A preferred heavy chain variable region is MF3755. Another preferred heavy chain variable region is MF4280. It has been shown that the antibodies comprising one or more variable domains with a heavy chain variable region MF3755 have a better effectivity when 20 used to inhibit growth of an EGFR ligand responsive cancer or cell. In the context of bispecific antibodies, an arm of the antibody comprising a variable domain with a heavy chain variable region MF3755 combines better with a variety of other arms comprising variable domains that bind extra-cellular parts of other cell surface proteins. Antibodies comprising a variable domain with heavy chain variable region 25   MF4280 also work well with a variable domain that binds LGR4, LGR5, LGR6, ZNRF3 or RNF43. In one embodiment the invention provides a bispecific antibody comprising a variable domain that binds ErbB-3, wherein a heavy chain variable region of said 30 variable domain comprises at least the CDR3 sequence of an ErbB-3 specific heavy chain variable region selected from the group consisting of MF3125; MF3176; MF3178; or MF4863 as depicted in Figure 1 or wherein a heavy chain variable region of said variable domain comprises a heavy chain CDR3 sequence that differs in at most three, preferably in at most two, preferably in no more than one amino acid 2023222928 31 Aug 2023 from a CDR3 sequence of a VH selected from the group consisting of MF3125; MF3176; MF3178; or MF4863 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR3 sequence of MF3125; MF3176; MF3178; or MF4863 as depicted in Figure 1. 5          Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of an ErbB-3 specific heavy chain variable region selected from the group consisting of MF3125; MF3176; MF3178; or MF4863 as depicted in Figure 1, or heavy chain CDR1, CDR2 and CDR3 sequences that differ in at most three, preferably in at most two, preferably in at 10 most one amino acid from the CDR1, CDR2 and CDR3 sequences of ErbB-3 specific heavy chain variable region selected from the group consisting of MF3125; MF3176; MF3178; or MF4863 as depicted in Figure 1. Variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of MF3125; MF3176; MF3178; or MF4863 as depicted in Figure 1. A 15 preferred heavy chain variable region is MF3178. In one embodiment the invention provides a bispecific antibody comprising a variable domain that binds LGR4, wherein a heavy chain variable region of said variable domain comprises at least the CDR3 sequence of an LGR4 specific heavy 20 chain variable region selected from the group consisting of MF5777; or MF5781 as depicted in Figure 1 or wherein a heavy chain variable region of said variable domain comprises a heavy chain CDR3 sequence that differs in at most three, preferably in at most two, preferably in no more than one amino acid from a CDR3 sequence of a VH selected from the group consisting of MF5777; or MF5781 as depicted in Figure 25   1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR3 sequence of MF5777; or MF5781 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region 30 comprising at least the CDR1, CDR2 and CDR3 sequences of an LGR4 specific heavy chain variable region selected from the group consisting of MF5777; or MF5781 as depicted in Figure 1, or heavy chain CDR1, CDR2 and CDR3 sequences that differ in at most three, preferably in at most two, preferably in at most one amino acid from the CDR1, CDR2 and CDR3 sequences of LGR4 specific heavy chain variable region 2023222928 31 Aug 2023 selected from the group consisting of MF5777; or MF5781 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of MF5777; or MF5781 as depicted in Figure 1. A preferred heavy chain variable region is MF5781. 5 In one embodiment the invention provides a bispecific antibody comprising a variable domain that binds LGR5, wherein a heavy chain variable region of said bispecific antibody comprises at least the CDR3 sequence of an LGR5 specific heavy chain variable region selected from the group consisting of MF5790; MF5803; 10   MF5805; MF5808; MF5809; MF5814; MF5816; MF5817; or MF5818 as depicted in Figure 1 or wherein a heavy chain variable region of variable domain comprises a heavy chain CDR3 sequence that differs in at most three, preferably in at most two, preferably in no more than one amino acid from a CDR3 sequence of a VH selected from the group consisting of MF5790; MF5803; MF5805; MF5808; MF5809; MF5814; 15   MF5816; MF5817; or MF5818 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR3 sequence of MF5790; MF5803; MF 5805; MF5808; MF5809; MF5814; MF5816; MF5817; or MF5818 as depicted in Figure 1. 20          Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of an LGR5 specific heavy chain variable region selected from the group consisting of MF5790; MF5803; MF5805; MF5808; MF5809; MF5814; MF5816; MF5817; or MF5818 as depicted in Figure 1, or heavy chain CDR1, CDR2 and CDR3 sequences that differ in at most 25   three, preferably in at most two, preferably in at most one amino acid from the CDR1, CDR2 and CDR3 sequences of LGR5 specific heavy chain variable region selected from the group consisting of MF5790; MF5803; MF5805; MF5808; MF5809; MF5814; MF5816; MF5817; or MF5818 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, 30 CDR2 and CDR3 sequences of MF5790; MF5803; MF5805; MF5808; MF5809; MF5814; MF5816; MF5817; or MF5818 as depicted in Figure 1. Preferred heavy chain variable regions are MF5790; MF5803; MF5814; MF5816; MF5817; or MF5818. Particularly preferred heavy chain variable regions are MF5790; MF5814; MF5816; and MF5818; preferably MF5814, MF5818 and MF5816, heavy chain 2023222928 31 Aug 2023 variable region MF5816 is particularly preferred. Another preferred heavy chain variable region is MF5818. In one embodiment the invention provides a bispecific antibody comprising a 5 variable domain that binds RNF43, wherein a heavy chain variable region of said variable domain comprises at least the CDR3 sequence of an RNF43 specific heavy chain variable region selected from the group consisting of MF5832; MF5836; or MF5839 as depicted in Figure 1 or wherein a heavy chain variable region of said variable domain comprises a heavy chain variable region comprising a heavy chain 10 CDR3 sequence that differs in at most three, preferably in at most two, preferably in no more than one amino acid from a CDR3 sequence of a VH selected from the group consisting of MF5832; MF5836; or MF5839 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR3 sequence of MF5832; MF5836; or MF5839 as depicted in Figure 1. 15 Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of an RNF43 specific heavy chain variable region selected from the group consisting of MF5832; MF5836; or MF5839 as depicted in Figure 1, or heavy chain CDR1, CDR2 and CDR3 sequences 20 that differ in at most three, preferably in at most two, preferably in at most one amino acid from the CDR1, CDR2 and CDR3 sequences of RNF43 specific heavy chain variable region selected from the group consisting of MF5832; MF5836; or MF5839 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of 25   MF5832; MF5836; or MF5839 as depicted in Figure 1. Preferred heavy chains are MF5832; or MF5836. A preferred heavy chain variable region is MF5836. In one embodiment the invention provides a bispecific antibody comprising a variable domain that binds ZNRF3, wherein a heavy chain variable region of said 30 variable domain comprises at least the CDR3 sequence of an ZNRF3 specific heavy chain variable region selected from the group consisting of MF5850; MF5853; MF5855; MF5862; MF5882; MF5884; MF5887; or MF5888 as depicted in Figure 1 or wherein a heavy chain variable region of said variable domain comprises a heavy chain CDR3 sequence that differs in at most three, preferably in at most two, 2023222928 31 Aug 2023 preferably in no more than one amino acid from a CDR3 sequence of a VH selected from the group consisting of MF5850; MF5853; MF5855; MF5862; MF5882; MF5884; MF5887; or MF5888 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR3 sequence of 5  MF5850; MF5853; MF5855; MF5862; MF5882; MF5884; MF5887; or MF5888 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of an ZNRF3 specific 10 heavy chain variable region selected from the group consisting of MF5850; MF5853; MF5855; MF5862; MF5882; MF5884; MF5887; or MF5888 as depicted in Figure 1, or heavy chain CDR1, CDR2 and CDR3 sequences that differ in at most three, preferably in at most two, preferably in at most one amino acid from the CDR1, CDR2 and CDR3 sequences of ZNRF3 specific heavy chain variable region selected 15 from the group consisting of MF5850; MF5853; MF5855; MF5862; MF5882; MF5884; MF5887; or MF5888 as depicted in Figure 1. Said variable domain preferably comprises a heavy chain variable region comprising at least the CDR1, CDR2 and CDR3 sequences of MF5850; MF5853; MF5855; MF5862; MF5882; MF5884; MF5887; or MF5888 as depicted in Figure 1. Preferred heavy chain variable regions 20 are MF5850; MF5853; MF5855; MF5884; or MF5888. Preferred heavy chain variable regions are MF5888 and MF5850, preferably MF5850. CDR sequences are for instance varied for optimization purposes, preferably in order to improve binding strength or the stability of the antibody. Optimization is 25 for instance performed by mutagenesis procedures where after the stability and / or binding affinity of the resulting antibodies are preferably tested and an improved EGFR or ErbB 3 -specific CDR sequence is preferably selected. A skilled person is well capable of generating antibody variants comprising at least one altered CDR sequence according to the invention. For instance, conservative amino acid 30 substitution may be applied. Examples of conservative amino acid substitution include the substitution of one hydrophobic residue such as isoleucine, valine, leucine or methionine for another hydrophobic residue, and the substitution of one polar residue for another polar residue, such as the substitution of arginine for lysine, glutamic acid for aspartic acid, or glutamine for asparagine. 2023222928 31 Aug 2023 The bispecific antibody of the invention that comprises a variable domain that binds EGFR, preferably comprises the VH chain of said variable domain comprises the amino acid sequence of VH chain MF3370; MF3755; MF4280 or MF4289 as 5 depicted in Figure 1; or the amino acid sequence of VH chain MF3370; MF3755; MF4280 or MF4289 depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect to the VH chain sequence of Figure 1. The bispecific antibody of the invention that comprises a variable domain 10 that binds EGFR, preferably comprises the VH chain of said variable domain and preferably comprises the amino acid sequence of VH chain MF3755. In a preferred embodiment this bispecific antibody comprises a variable domain that binds a membrane associated member of the WNT pathway as defined elsewhere herein. In a preferred embodiment the membrane associated member of the WNT pathway is 15 LGR4, LGR5, RNF43 or ZNRF3. The bispecific antibody of the invention that comprises a variable domain that binds HER3, preferably comprises the VH chain of said variable domain comprises the amino acid sequence of VH chain MF3125; MF3176; MF3178; or MF4863 as 20 depicted in Figure 1; or the amino acid sequence of VH chain MF3125; MF3176; MF3178; or MF4863 depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect to the VH chain sequence of Figure 1. A preferred heavy chain is MF3178. In a preferred embodiment this 25 bispecific antibody comprises a variable domain that binds a membrane associated member of the WNT pathway as defined elsewhere herein. In a preferred embodiment the membrane associated member of the WNT pathway is LGR4, LGR5, RNF43 or ZNRF3. 30          The bispecific antibody of the invention that comprises a variable domain that binds LGR4, preferably comprises the VH chain of said variable domain comprises the amino acid sequence of VH chain MF5777; or MF5781 as depicted in Figure 1; or the amino acid sequence of VH chain MF5777; or MF5781 depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 2023222928 31 Aug 2023 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect to the VH chain sequence of Figure 1. In a preferred embodiment this bispecific antibody comprises a variable domain that binds an extracellular part of membrane associated member of the EGFR family as defined elsewhere herein. In a 5 preferred embodiment the membrane associated member of the EGFR family is EGFR or HER3, preferably EGFR. A preferred heavy chain is MF3755. The bispecific antibody of the invention that comprises a variable domain that binds LGR5, preferably comprises the VH chain of said variable domain comprises 10 the amino acid sequence of VH chain MF5790; MF5803; MF5805; MF5808; MF5809; MF5814; MF5816; MF5817; or MF5818 as depicted in Figure 1; or the amino acid sequence of VH chain MF5790; MF5803; MF5805; MF5808; MF5809; MF5814; MF5816; MF5817; or MF5818 depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, 15 deletions, substitutions or a combination thereof with respect to the VH chain sequence of Figure 1. In a preferred embodiment this bispecific antibody comprises a variable domain that binds an extracellular part of membrane associated member of the EGFR family as defined elsewhere herein. In a preferred embodiment the membrane associated member of the EGFR family is EGFR or HER3, preferably 20 EGFR. A preferred heavy chain is MF3755. The bispecific antibody of the invention that comprises a variable domain that binds RNF43, preferably comprises the VH chain of said variable domain comprises the amino acid sequence of VH chain MF5832; MF5836; or MF5839 as depicted in 25 Figure 1; or the amino acid sequence of VH chain MF5832; MF5836; or MF5839 depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect to the VH chain sequence of Figure 1. In a preferred embodiment the bispecific antibody comprises a variable domain that binds an 30 extracellular part of membrane associated member of the EGFR family as defined elsewhere herein. In a preferred embodiment the membrane associated member of the EGFR family is EGFR or HER3, preferably EGFR. A preferred heavy chain is MF3755. 2023222928 31 Aug 2023 The bispecific antibody of the invention that comprises a variable domain that binds ZNRF3, preferably comprises the VH chain of said variable domain comprises the amino acid sequence of VH chain MF5850; MF5853; MF5855; MF5862; MF5882; MF5884; MF5887; or MF5888 as depicted in Figure 1; or the amino acid sequence of 5 VH chain MF5850; MF5853; MF5855; MF5862; MF5882; MF5884; MF5887; or MF5888 depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect to the VH chain sequence of Figure 1. In a preferred embodiment the bispecific antibody comprises a variable domain that 10 binds an extracellular part of membrane associated member of the EGFR family as defined elsewhere herein. In a preferred embodiment the membrane associated member of the EGFR family is EGFR or HER3, Preferably EGFR. A preferred heavy chain is MF3755. 15          Preferably, the mentioned amino acid insertions, deletions and substitutions in a VH or VL as specified herein are not present in the CDR3 region. The mentioned amino acid insertions, deletions and substitutions are also preferably not present in the CDR1 and CDR2 regions. The mentioned amino acid insertions, deletions and substitutions are also preferably not present in the FR4 region. 20 The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds LGR4 wherein the VH chain of the variable domain that binds EGFR comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or 25         - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds LGR4 comprises 30         - the amino acid sequence of VH chain MF5777 as depicted in Figure 1 ; or - the amino acid sequence of VH chain MF5777 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 2023222928 31 Aug 2023 The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds LGR4 wherein the VH chain of the variable domain that binds EGFR comprises 5         - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and 10         wherein the VH chain of the variable domain that binds LGR4 comprises - the amino acid sequence of VH chain MF5781 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5781 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 15 respect said VH. The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds LGR5 wherein the VH chain of the variable domain that binds EGFR comprises 20         - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and 25         wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5790 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5790 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 30 respect said VH. The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds LGR5 wherein the VH chain of the variable domain that binds EGFR comprises 2023222928 31 Aug 2023 - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 5 respect said VH; and wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5803 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5803 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 10   5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds LGR5 wherein the VH chain of the 15 variable domain that binds EGFR comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 20 respect said VH; and wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5814 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5814 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 25   5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds LGR5 wherein the VH chain of the 30 variable domain that binds EGFR comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 2023222928 31 Aug 2023 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5816 as depicted in Figure 1; or 5         - the amino acid sequence of VH chain MF5816 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 10          The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds LGR5 wherein the VH chain of the variable domain that binds EGFR comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having 15 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5817 as depicted in Figure 1; or 20         - the amino acid sequence of VH chain MF5817 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 25          The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds LGR5 wherein the VH chain of the variable domain that binds EGFR comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having 30 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5818 as depicted in Figure 1; or 2023222928 31 Aug 2023 - the amino acid sequence of VH chain MF5818 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 5 The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds RNF43 wherein the VH chain of the variable domain that binds EGFR comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or 10         - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds RNF43 comprises 15         - the amino acid sequence of VH chain MF5832 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5832 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 20 The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds RNF43 wherein the VH chain of the variable domain that binds EGFR comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or 25         - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds RNF43 comprises 30         - the amino acid sequence of VH chain MF5836 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5836 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 2023222928 31 Aug 2023 The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds ZNRF3 wherein the VH chain of the variable domain that binds EGFR comprises 5         - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and 10         wherein the VH chain of the variable domain that binds ZNRF3 comprises - the amino acid sequence of VH chain MF5850 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5850 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 15 respect said VH. The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds ZNRF3 wherein the VH chain of the variable domain that binds EGFR comprises 20         - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and 25         wherein the VH chain of the variable domain that binds ZNRF3 comprises - the amino acid sequence of VH chain MF5853 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5853 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 30 respect said VH. The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds ZNRF3 wherein the VH chain of the variable domain that binds EGFR comprises 2023222928 31 Aug 2023 - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 5 respect said VH; and wherein the VH chain of the variable domain that binds ZNRF3 comprises - the amino acid sequence of VH chain MF5855 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5855 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 10   5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds ZNRF3 wherein the VH chain of the 15 variable domain that binds EGFR comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 20 respect said VH; and wherein the VH chain of the variable domain that binds ZNRF3 comprises - the amino acid sequence of VH chain MF5884 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5884 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 25   5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides an antibody comprising a variable domain that binds EGFR and a variable domain that binds ZNRF3 wherein the VH chain of the 30 variable domain that binds EGFR comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 2023222928 31 Aug 2023 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds ZNRF3 comprises - the amino acid sequence of VH chain MF5888 as depicted in Figure 1; or 5         - the amino acid sequence of VH chain MF5888 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 10          The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds LGR4 wherein the VH chain of the variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having 15 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds LGR4 comprises - the amino acid sequence of VH chain MF5777 as depicted in Figure 1; or 20         - the amino acid sequence of VH chain MF5777 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 25          The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds LGR4 wherein the VH chain of the variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having 30 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds LGR4 comprises - the amino acid sequence of VH chain MF5781 as depicted in Figure 1; or 2023222928 31 Aug 2023 - the amino acid sequence of VH chain MF5781 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 5 The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds LGR5 wherein the VH chain of the variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or 10         - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds LGR5 comprises 15         - the amino acid sequence of VH chain MF5790 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5790 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 20 The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds LGR5 wherein the VH chain of the variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or 25         - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds LGR5 comprises 30         - the amino acid sequence of VH chain MF5803 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5803 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 2023222928 31 Aug 2023 The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds LGR5 wherein the VH chain of the variable domain that binds HER3 comprises 5         - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and 10         wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5814 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5814 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 15 respect said VH. The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds LGR5 wherein the VH chain of the variable domain that binds HER3 comprises 20         - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and 25         wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5816 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5816 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 30 respect said VH. The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds LGR5 wherein the VH chain of the variable domain that binds HER3 comprises 2023222928 31 Aug 2023 - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 5 respect said VH; and wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5817 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5817 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 10   5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds LGR5 wherein the VH chain of the 15 variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 20 respect said VH; and wherein the VH chain of the variable domain that binds LGR5 comprises - the amino acid sequence of VH chain MF5818 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5818 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 25   5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds RNF43 wherein the VH chain of the 30 variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 2023222928 31 Aug 2023 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds RNF43 comprises - the amino acid sequence of VH chain MF5836 as depicted in Figure 1; or 5         - the amino acid sequence of VH chain MF5836 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 10          The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds ZNRF3 wherein the VH chain of the variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having 15 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds ZNRF3 comprises - the amino acid sequence of VH chain MF5850 as depicted in Figure 1; or 20         - the amino acid sequence of VH chain MF5850 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 25          The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds ZNRF3 wherein the VH chain of the variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having 30 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds ZNRF3 comprises - the amino acid sequence of VH chain MF5853 as depicted in Figure 1; or 2023222928 31 Aug 2023 - the amino acid sequence of VH chain MF5853 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 5 The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds ZNRF3 wherein the VH chain of the variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or 10         - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds ZNRF3 comprises 15         - the amino acid sequence of VH chain MF5855 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5855 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 20 The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds ZNRF3 wherein the VH chain of the variable domain that binds HER3 comprises - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or 25         - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and wherein the VH chain of the variable domain that binds ZNRF3 comprises 30         - the amino acid sequence of VH chain MF5884 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5884 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 2023222928 31 Aug 2023 The invention also provides an antibody comprising a variable domain that binds HER3 and a variable domain that binds ZNRF3 wherein the VH chain of the variable domain that binds HER3 comprises 5         - the amino acid sequence of VH chain MF3178 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3178 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH; and 10         wherein the VH chain of the variable domain that binds ZNRF3 comprises - the amino acid sequence of VH chain MF5888 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5888 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 15 respect said VH. A protein or bispecific antibody of the present invention is preferably used in humans. To this end an antibody of the invention is preferably a human or humanized antibody. Tolerance of a human to a polypeptide is governed by many 20 different aspects. Immunity, be it T-cell mediated, B-cell mediated or other is one of the variables that are encompassed in tolerance of the human for a polypeptide. The constant region of a bispecific antibody of the present invention is preferably a human constant region (Figure 4). The constant region may contain one or more, preferably not more than 10, preferably not more than 5 amino-acid differences with 25 the constant region of a naturally occurring human antibody. It is preferred that the constant part is entirely derived from a naturally occurring human antibody. Various antibodies produced herein are derived from common light chain mice immunized with the respective target as described in WO2009 / 157771. Various antibodies produced herein are derived from a human antibody variable domain 30 library. As such these variable domains are human. The unique CDR regions may be derived from humans, be synthetic or derived from another organism. The variable region is considered a human variable region when it has an amino acid sequence that is identical to an amino acid sequence of the variable region of a naturally occurring human antibody, but for the CDR regions. The variable region 2023222928 31 Aug 2023 of a VH of antibody that binds a EGFR-family member or membrane associated member of the WNT pathway, or a light chain in an antibody of the invention may contain one or more, preferably not more than 10, preferably not more than 5 aminoacid differences with the variable region of a naturally occurring human antibody, 5 not counting possible differences in the amino acid sequence of the CDR regions. Such mutations also occur in nature in the context of somatic hypermutation. Antibodies may be derived from various animal species, at least with regard to the heavy chain variable region. It is common practice to humanize such e.g. 10 murine heavy chain variable regions. There are various ways in which this can be achieved among which there are CDR-grafting into a human heavy chain variable region with a 3D-structure that matches the 3-D structure of the murine heavy chain variable region; de-immunization of the murine heavy chain variable region, preferably done by removing known or suspected T- or B- cell epitopes from the 15 murine heavy chain variable region. The removal is typically by substituting one or more of the amino acids in the epitope for another (typically conservative) amino acid, such that the sequence of the epitope is modified such that it is no longer a Tor B-cell epitope. 20         De-immunized murine heavy chain variable regions are less immunogenic in humans than the original murine heavy chain variable region. Preferably a variable region or domain of the invention is further humanized, such as for instance veneered. By using veneering techniques, exterior residues which are readily encountered by the immune system are selectively replaced with human residues to 25 provide a hybrid molecule that comprises either a weakly immunogenic or substantially non-immunogenic veneered surface. An animal as used in the invention is preferably a mammal, more preferably a primate, most preferably a human. 30          A protein or bispecific antibody according to the invention preferably comprises a constant region of a human antibody. According to differences in their heavy chain constant domains, antibodies are grouped into five classes, or isotypes: IgG, IgA, IgM, IgD, and IgE. These classes or isotypes comprise at least one of said heavy chains that is named with a corresponding Greek letter. In a preferred 2023222928 31 Aug 2023 embodiment the invention provides an antibody according to the invention wherein said constant region is selected from the group of IgG, IgA, IgM, IgD, and IgE constant regions, more preferably said constant region comprises an IgG constant region, more preferably an IgGl constant region (Figure 4), preferably a mutated 5 IgGl constant region. Some variation in the constant region of IgGl occurs in nature and / or is allowed without changing the immunological properties of the resulting antibody. Typically between about 1-10 amino acid insertions, deletions, substitutions or a combination thereof are allowed in the constant region. 10         Rational methods have evolved toward minimizing the content of non-human residues in the human context. Various methods are available to successfully graft the antigen-binding property of an antibody onto another antibody. The binding properties of antibodies rest predominantly in the exact sequence of the CDR3 region, often supported by the sequence of the CDR1 and CDR2 regions in the 15 variable domain combined with the appropriate structure of the variable domain as a whole. Various methods are presently available to graft CDR regions onto a suitable variable domain of another antibody. Some of these methods are reviewed in J.C. Almagrol and J. Fransson (2008) Frontiers in Bioscience 13, 1619-1633, which is included by reference herein. 20 The mentioned at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably 1, 2, 3, 4 or 5 amino acid substitutions are preferably conservative amino acid substitutions, the insertions, deletions, substitutions or a combination thereof are preferably not in the CDR3 region of the VH chain, preferably not in the CDR1, 25 CDR2 or CDR3 region of the VH chain and preferably not in the FR4 region. The light chain of a variable domain comprising a variable heavy chain sequence as depicted in Figure 3, is preferably a germline light chain of or based on 012, preferably the rearranged germline human kappa light chain IgVKl- 30   39*01 / IGJk1*01 or a fragment or a functional derivative thereof (nomenclature according to the IMGT database worldwide web at imgt.org). The terms rearranged germline human kappa light chain IgVKl-39*01 / IGJKl*01, IGKV1-39 / IGKJ1, huVxl-39 light chain or in short huVKl-39 are used. The light chain can have 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or combination thereof. The 2023222928 31 Aug 2023 mentioned 1, 2, 3, 4 or 5 amino acid substitutions are preferably conservative amino acid substitutions, the insertions, deletions, substitutions or combination thereof are preferably not in the CDR3 region of the VL chain, preferably not in the CDR1, CDR2 or CDR3 region or FR4 region of the VL chain. 5 Various methods are available to produce bispecific antibodies. One method involves the expression of two different heavy chains and two different light chains in a cell and collecting antibody that is produced by the cell. Antibody produced in this way will typically contain a collection of antibodies with different combinations 10 of heavy and light chains, some of which are the desired bispecific antibody. The bispecific antibody can subsequently be purified from the collection. The ratio of bispecific to other antibodies that are produced by the cell can be increased in various ways. In a preferred embodiment of the invention, the ratio is increased by expressing not two different light chains but two essentially identical light chains in 15 the cell. This concept is in the art also referred to as the “common light chain” method. When the essentially identical light chains work together with the two different heavy chains allowing the formation of variable domains with different antigen-binding sites and concomitant different binding properties, the ratio of bispecific antibody to other antibody that is produced by the cell is significantly 20 improved over the expression of two different light chains. The ratio of bispecific antibody that is produced by the cell can be further improved by stimulating the pairing of two different heavy chains with each other over the pairing of two identical heavy chains. The art describes various ways in which such hetero-dimerization of heavy chains can be achieved. One way is to generate 'knob into hole' bispecific 25 antibodies. See US Patent Application 20030078385 (Arathoon et al. - Genentech). Another method is by using charge engineering as described in Gunasekaran (JBC 2010, vol 285, pp 19637-19646). Another and preferred method is described in US provisional application 61 / 635,935, which has been followed up by US regular application No. 13 / 866,747 and PCT application No. PCT / NL2013 / 050294 (WO 30   2013 / 157954 Al), which are incorporated herein by reference. Methods and means are disclosed for producing bispecific antibodies (from a single cell), whereby means are provided that favor the formation of bispecific antibodies over the formation of monospecific antibodies. These methods can also be favorably employed in the present invention. Thus the invention provides a method for producing a bispecific 2023222928 31 Aug 2023 antibody according to the invention (from a single cell), wherein said bispecific antibody comprises two CH3 domains that are capable of forming an interface, said method comprising providing in said cell a) a first nucleic acid molecule encoding a 1st CH3 domain comprising heavy chain, b) a second nucleic acid molecule encoding 5 a 2nd CH3 domain comprising heavy chain, wherein said nucleic acid molecules are provided with means for preferential pairing of said 1st and 2nd CH3 domain comprising heavy chains, said method further comprising the step of culturing said host cell and allowing for expression of said two nucleic acid molecules and harvesting said bispecific antibody from the culture. Said first and second nucleic 10 acid molecules may be part of the same nucleic acid molecule, vector or gene delivery vehicle and may be integrated at the same site of the host cell’s genome. Alternatively, said first and second nucleic acid molecules are separately provided to said cell. 15          A preferred embodiment provides a method for producing a bispecific antibody according to the invention from a single cell, wherein said bispecific antibody comprises two CH3 domains that are capable of forming an interface, said method comprising providing: - a cell having a) a first nucleic acid molecule encoding a heavy chain comprising an 20 antigen binding site that binds an extra-cellular part of a membrane associated member of the EGFR family and that contains a 1st CH3 domain, and b) a second nucleic acid molecule encoding a heavy chain comprising an antigen-binding site that binds an extra-cellular part of a membrane associated member of a WNT signaling pathway and that contains a 2nd CH3 domain, wherein said nucleic acid 25 molecules are provided with means for preferential pairing of said 1st and 2nd CH3 domains, said method further comprising the step of culturing said cell and allowing for expression of the proteins encoded by said two nucleic acid molecules and harvesting said bispecific IgG antibody from the culture. In a particularly preferred 30 embodiment, said cell also has a third nucleic acid molecule encoding a common light chain. Said first, second and third nucleic acid molecule may be part of the same nucleic acid molecule, vector or gene delivery vehicle and may be integrated at the same site of the host cell’s genome. Alternatively, said first, second and third nucleic acid molecules are separately provided to said cell. A preferred common light chain 2023222928 31 Aug 2023 is based on 012, preferably it is the rearranged germline human kappa light chain IgVKl 39*01 / IGJk1*01, as described above. Means for preferential pairing of said 1st and said 2nd CH3 domain are preferably the corresponding mutations in the CH3 domain of the heavy chain coding regions. The preferred mutations to produce 5 essentially only bispecific antibodies are the amino acid substitutions L351K and T366K (numbering according to EU numbering) in the first CH3 domain and the amino acid substitutions L351D and L368E in the second CH3 domain, or vice versa. Further provided is therefore a method according to the invention for producing a bispecific antibody, wherein said first CH3 domain comprises the amino acid 10 substitutions L351K and T366K (numbering according to EU numbering) and wherein said second CH3 domain comprises the amino acid substitutions L351D and L368E, said method further comprising the step of culturing said cell and allowing for expression of proteins encoded by said nucleic acid molecules and harvesting said bispecific antibody from the culture. Also provided is a method according to the 15 invention for producing a bispecific antibody, wherein said first CH3 domain comprises the amino acid substitutions L351D and L368E (numbering according to EU numbering) and wherein said second CH3 domain comprises the amino acid substitutions L351K and T366K, said method further comprising the step of culturing said cell and allowing for expression of said nucleic acid molecules and 20 harvesting said bispecific antibody from the culture. Antibodies that can be produced by these methods are also part of the present invention. The CH3 heterodimerization domains are preferably IgGl hetero-dimerization domains. The heavy chain constant regions comprising the CH3 hetero-dimerization domains are preferably IgGl constant regions. 25 In one embodiment the invention provides a nucleic acid molecule encoding an antibody heavy chain variable region according to the invention. The nucleic acid molecule (typically an in vitro, isolated or recombinant nucleic acid molecule) preferably encodes a heavy chain variable region as depicted in Figure 1 or a heavy 30 chain variable region as depicted in Figure 1 having 1 , 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or combination thereof. In a preferred embodiment the nucleic acid molecule comprises a sequence as depicted in Figure 2. In another preferred embodiment the nucleic acid molecule encodes the same amino acid sequence as the nucleic acid depicted in Figure 2 but has a different sequence 2023222928 31 Aug 2023 because it encodes one or more different codons. The invention further provides a nucleic acid sequence encoding a heavy chain of Figure 1. A nucleic acid molecule as used in the invention is typically but not 5 exclusively a ribonucleic acid (RNA) or a deoxyribonucleic acid (DNA). Alternative nucleic acids are available for a person skilled in the art. A nucleic acid according to the invention is for instance comprised in a cell. When said nucleic acid is expressed in said cell, said cell can produce an antibody according to the invention. Therefore, the invention in one embodiment provides a cell comprising an antibody according 10 to the invention and / or a nucleic acid according to the invention. Said cell is preferably an animal cell, more preferably a mammal cell, more preferably a primate cell, most preferably a human cell. For the purposes of the invention a suitable cell is any cell capable of comprising and preferably of producing an antibody according to the invention and / or a nucleic acid according to the invention. 15 The invention further provides a cell comprising an antibody according to the invention. Preferably said cell (typically an in vitro, isolated or recombinant cell) produces said antibody. In a preferred embodiment said cell is a hybridoma cell, a Chinese hamster ovary (CHO) cell, an NSO cell or a PER-C6TM cell. In a particularly 20 preferred embodiment said cell is a CHO cell. Further provided is a cell culture comprising a cell according to the invention. Various institutions and companies have developed cell lines for the large scale production of antibodies, for instance for clinical use. Non-limiting examples of such cell lines are CHO cells, NSO cells or PER.C6 cells. These cells are also used for other purposes such as the production of 25 proteins. Cell lines developed for industrial scale production of proteins and antibodies are herein further referred to as industrial cell lines. Thus in a preferred embodiment the invention provides the use of a cell line developed for the large scale production of antibody for the production of an antibody of the invention. The invention further provides a cell for producing an antibody comprising a nucleic acid 30 molecule that codes for a VH, a VL, and / or a heavy chain as depicted in Figure 1. Preferably said nucleic acid molecule comprises a sequence as depicted in Figure 2. The invention further provides a method for producing an antibody comprising culturing a cell of the invention and harvesting said antibody from said 2023222928 31 Aug 2023 culture. Preferably said cell is cultured in a serum free medium. Preferably said cell is adapted for suspension growth. Further provided is an antibody obtainable by a method for producing an antibody according to the invention. The antibody is preferably purified from the medium of the culture. Preferably said antibody is 5 affinity purified. A cell of the invention is for instance a hybridoma cell line, a CHO cell, a 293F cell, an NSO cell or another cell type known for its suitability for antibody production for clinical purposes. In a particularly preferred embodiment said cell is a human 10 cell. Preferably a cell that is transformed by an adenovirus El region or a functional equivalent thereof. A preferred example of such a cell line is the PER.C6 cell line or equivalent thereof. In a particularly preferred embodiment said cell is a CHO cell or a variant thereof. Preferably a variant that makes use of a Glutamine synthetase (GS) vector system for expression of an antibody. 15 The invention further provides a pharmaceutical composition comprising an antibody according to the invention. The pharmaceutical composition preferably comprises a preferably pharmaceutically acceptable excipient or carrier. In a preferred embodiment the pharmaceutical composition comprises 5-50 mM 20 Histidine, 100-300 mM Trehalose, 0.1-03 g / L PolySorbate20 or a combination thereof. The pH is preferably set at pH = 5.5 — 6.5. In a preferred embodiment the pharmaceutical composition comprises 25 mM Histidine, 220 mM Trehalose, 0.2 g / L PolySorbate20 or a combination thereof. The pH is preferably set at pH = 5.5-6.5, most preferably at pH = 6. 25 An antibody of the invention preferably further comprises a label, preferably a label for in vivo imaging. Such a label is typically not necessary for therapeutic applications. In for instance a diagnostic setting, a label can be helpful. For instance in visualizing target cells in the body. Various labels are suited and many are well 30 known in the art. In a preferred embodiment the label is a radioactive label for detection. In another preferred embodiment, the label is an infrared label. Preferably the infrared label is suited for in vivo imaging. Various infrared labels are available to the person skilled in the art. Preferred infrared labels are for instance, IRDye 800; IRDye 680RD; IRDye 680LT; IRDye 750; IRDye 700DX; IRDye 800RS IRDye 650; 2023222928 31 Aug 2023 IRDye 700 phosphoramidite; IRDye 800 phosphoramidite (LI-COR USA; 4647 Superior Street; Lincoln, Nebraska). To establish whether a cancer exhibits a growth response when provided with 5 an EGF receptor family member ligand, the skilled person can for instance determine the EGFR amplification and / or staining immune-histochemistry (for an EGF-response). At least 10% of the tumor cells in a tumor sample should be positive. The tumor sample can also contain 20%, 30% 40% 50% 60% 70% or more positive cells. To establish whether a cancer exhibits a growth response to a HER3 ligand the 10 skilled person can for instance determine the HER3 amplification and / or staining in immunohistochemistry. At least 10% tumor cells in a tumor sample should be positive. The sample can also contain 20%, 30% 40% 50% 60% 70% or more positive cells. To establish whether a cancer will be sensitive to Wnt (LGR5, LGR4, ZNRF3, RNF43) receptor targeting the skilled person can for instance determine the Wnt 15 target amplification and / or staining in immunohistochemistry. At least 1% tumor cells in a tumor sample should be positive. The sample can also contain 5%, 10% 20% 30% 40% 50% or more positive cells. The amount of antibody according to the invention to be administered to a 20 patient is typically in the therapeutic window, meaning that a sufficient quantity is used for obtaining a therapeutic effect, while the amount does not exceed a threshold value leading to an unacceptable extent of side-effects. The lower the amount of antibody needed for obtaining a desired therapeutic effect, the larger the therapeutic window will typically be. An antibody according to the invention exerting sufficient 25 therapeutic effects at low dosage is, therefore, preferred. The dosage can be in range of the dosing regimen of cetuximab. The dosage can also be lower. A bispecific antibody according to the invention preferably induces less skin toxicity as compared to cetuximab under otherwise similar conditions of course. A 30 bispecific antibody according to the invention preferably produces less proinflammatory chemokines, preferably of CXCL14 as compared to cetuximab under otherwise similar conditions of course. A bispecific antibody according to the invention preferably induces less impairment of antimicrobial RNAses, preferably Rnase 7, as compared to cetuximab under otherwise similar conditions of course. 2023222928 31 Aug 2023 The present invention describes among others antibodies that target the an extra-cellular part of a membrane associated member of the EGF receptor family and an extra-cellular part of a membrane associated member of the WNT signaling 5 pathway and result in potent proliferation inhibition of cancer cell lines in vitro and tumor growth inhibition in vivo. The antibodies were produced as bispecific antibodies by cloning them into complementary expression vectors that contain mutations in the CH3 region that drives hetero-dimerization of heavy chains. Many bispecific antibodies were produced at small scale and tested in binding and 10 functional assays on cancer cell lines. An antibody of the invention, particularly a bispecific antibody of the invention can combine low toxicity profiles with high efficacy. An antibody of the invention can be useful in various types and lines of EGFR family member targeted therapies. An antibody of the invention can have an increased therapeutic window when compared to an antibody that binds the same 15 antigen(s) with both arms. A bispecific antibody of the invention can exhibit better growth inhibitory effects in vitro, in vivo or a combination thereof when compared to the MEHD7945A antibody. Also provided is a method for counteracting the formation of a metastasis in 20 a subject having a cancer that expresses a member of the EGF-receptor family and that expresses a membrane associated member of the WNT pathway. The cancer is preferably an EGF-receptor ligand responsive cancer. High Her ligand (e.g. EGF, Heregulin) levels are typically present during the formation of metastases (i.e. the migration, invasion, growth and / or differentiation of tumor cells or tumor initiating 25 cells). Typically, tumor initiating cells are identified based on stem cell markers such as CD44. These processes can therefore barely be counteracted with currently known therapies like trastuzumab and pertuzumab. Since an antibody according to the invention is capable of counteracting growth and / or differentiation of tumor cells or tumor initiating cells such as cancer stem cells, such antibody according to the 30 invention is also particularly suitable for counteracting the formation of metastases. Further provided is therefore a method for counteracting the formation of a metastasis in a subject having a EGFR, ErbB-3 or EGFR / ErbB-3 positive tumor, wherein said EGFR, ErbB-3 or EGFR / ErbB-3 positive tumor cell and / or surrounding stromal tissue cells (e.g. fibroblasts, Leukocytes such as macrophages and 2023222928 31 Aug 2023 monocytes, endothelium, etc.) has a Her ligand expression level that is at least 60%, preferably at least 70%, more preferably at least 80%, more preferably at least 85%, more preferably at least 90% or 95% of the her ligand expression level of BXPC3 or MCF7 cells, comprising administering to the subject a bispecific antibody or a 5 functional part, derivative and / or analogue thereof that binds an extra-cellular part of EGFR or HER3, an extra-cellular part of a membrane associated member of the WNT signaling pathway. Also provided is a bispecific antibody or a functional part, derivative and / or analogue thereof that binds an extra-cellular part of EGFR or HER3, and an extra-cellular part of a membrane associated member of the WNT 10 signaling pathway, for use in the treatment or prevention of the formation of metastases. The tumor from which said metastases originate is preferably an ErbB-3 or EGFR / ErbB-3 positive tumor. The tumor and / or surrounding stromal tissue cells preferably has a her ligand expression level that is at least 60%, preferably at least 70%, more preferably at least 80%, more preferably at least 85%, more preferably at 15 least 90% or 95% of the heregulin expression level of BXPC3 or MCF7 cells. Further provided is a use of a bispecific antibody according to the invention or a functional part, derivative and / or analogue thereof, for the preparation of a medicament for the treatment or prevention of the formation of metastases. The 20 tumor from which said metastases originate is preferably an ErbB-3 or EGFR / ErbB-3 positive tumor. The tumor and / or surrounding stromal tissue cells preferably has a her ligand expression level that is at least 60%, preferably at least 70%, more preferably at least 80%, more preferably at least 85%, more preferably at least 90% or 95% of the heregulin expression level of BXPC3 or MCF7 cells. 25 Antibodies of the invention can be produced at levels > 50 mg / L after transient transfection in suspension 293F cells. The bispecific antibodies can be purified to greater than 98% purity with yields > 70%. Analytical characterization studies show bispecific IgGl antibody profiles that are comparable to bivalent 30 monospecific IgGl. For the purpose of clarity and a concise description features are described herein as part of the same or separate embodiments, however, it will be appreciated that the scope of the invention may include embodiments having combinations of all or some of the features described. 2023222928 31 Aug 2023 In mathematics, the Euclidean distance or Euclidean metric is the "ordinary" (i.e. straight-line) distance between two points in Euclidean space. With this distance, Euclidean space becomes a metric space. The associated norm is 5 called the Euclidean norm. Receptor tyrosine kinases (RTK)s are the high-affinity cell surface receptors for many polypeptide growth factors, cytokines, and hormones. Of the presently known 90 unique tyrosine kinase genes identified in the human genome, 58 encode 10 receptor tyrosine kinase proteins. Receptor tyrosine kinases have been shown to be relevant for normal cellular processes but also to have a role in the development and progression of cancer. Receptor tyrosine kinases contain at least one extracellular domain. 15          In one aspect the invention provides a protein that binds an extracellular part of a membrane associated member of the RTK receptor family and an extracellular part of a membrane associated member of a WNT signaling pathway. The protein is preferably an antibody, preferably a bispecific antibody or a functional part, derivative and / or analogue thereof. 20 The invention also provides a bispecific antibody or a functional part, derivative and / or analogue thereof that binds an extracellular part of a membrane associated member of the RTK receptor family and an extra-cellular part of a membrane associated member of a WNT-signaling pathway. 25 Also provided is a method for the treatment of an individual that has a cancer, the method comprising administering a protein of the invention or a bispecific antibody of the invention to the individual in need thereof. 30 The invention further provides a protein of the invention or a bispecific antibody of the invention, for use in the treatment of an individual that has cancer. 2023222928 31 Aug 2023 In one embodiment the cancer is a cancer that is responsive to the ligand of the respective member of the RTK receptor family and a cancer that expresses a membrane associated member of the WNT pathway. 5          Further provided is a cell system comprising a protein of the invention or a bispecific antibody of the invention, and a cell that expresses a membrane associated member of the RTK receptor family and that expresses a membrane associated member of the WNT pathway. The cell system is preferably is a cell system comprising a protein of the invention or a bispecific antibody of the 10 invention, and a cell that expresses a membrane associated member of the RTK receptor family and that expresses a membrane associated member of the WNT pathway. Also provided is a system permissive for inhibiting growth / proliferation of the cell, the method comprising providing the system with a protein of the 15 invention or a bispecific antibody of the invention. The cell is preferably is an RTK -receptor ligand responsive cell that expresses a membrane associated member of the WNT pathway in a system permissive for growth / proliferation of the cell, the method comprising providing the system with a protein of the invention or a bispecific antibody of the invention. The cell is preferably is an RTK -receptor 20 ligand responsive cell that expresses a membrane associated member of the WNT pathway. Preferred members of the RTK receptor family are the mentioned EGF-receptor family and c-MET; Axl and MST1R. 25 MET or C-MET is a single pass tyrosine kinase receptor relevant for embryonic development, organogenesis and wound healing. Hepatocyte growth factor / Scatter Factor (HGF / SF) and its splicing isoform (NK1, NK2) are the presently known ligands of the MET receptor. MET is normally expressed by cells 30 of epithelial origin, while expression of HGF / SF is observed in cells of mesenchymal origin. When HGF / SF binds its cognate receptor MET it induces activation. Met is also known as MET Proto-Oncogene, Receptor Tyrosine Kinase; Hepatocyte Growth Factor Receptor; Tyrosine-Protein Kinase Met; Scatter Factor Receptor; Proto-Oncogene C-Met; HGF / SF Receptor; HGF Receptor; SF Receptor; EC 2023222928 31 Aug 2023 2.7.10.1; Met Proto-Oncogene Tyrosine Kinase; Met Proto-Oncogene; EC 2.7.10; AUTS9; RCCP2; C-Met; and HGFR 3. Accession numbers for the gene and protein are NC_000007.14; NT_007933.16; NC_018918.2; NP_000236.2; NP_001120972.1. The accession numbers are primarily given to provide a further method of 5 identification of C-MET as a target, the actual sequence of the C-MET protein bound by an antibody may vary, for instance because of a mutation in the encoding gene such as those occurring in some cancers or the like. The C-MET antigen binding site binds C-MET and a variety of variants thereof, such as those expressed by some C-MET positive tumor cells. 10 AXL or AXL Receptor Tyrosine Kinase codes for Tyrosine-protein kinase receptor UFO which is an enzyme that in humans is encoded by the AXL gene. Other names for AXL are AXL Receptor Tyrosine Kinase; AXL Oncogene; EC 2.7.10.1; UFO; Tyrosine-Protein Kinase Receptor UFO; AXL Transforming 15 Sequence / Gene; EC 2.7.10; JTK11; Tyro7; and ARK 3. Accession numbers for the gene and protein are NC_000019.10; NC_018930.2; NT_011109.17; NP_001265528.1; NP_001690.2; NP_068713.2). The accession numbers are primarily given to provide a further method of identification of AXL as a target, the actual sequence of the AXL protein bound by an antibody may vary, for instance 20 because of a mutation in the encoding gene such as those occurring in some cancers or the like. The AXL antigen binding site binds AXL and a variety of variants thereof, such as those expressed by some AXL positive tumor cells. MST1R or Macrophage stimulating 1 receptor or RON. Other names for 25 MST1R are Macrophage Stimulating 1 Receptor; RON; PTK8 Protein Tyrosine Kinase 8; C-Met-Related Tyrosine Kinase; MSP Receptor; EC 2.7.10.1; P185-Ron; CDwl36; PTK8; Macrophage Stimulating 1 Receptor (C-Met-Related Tyrosine Kinase) 3; Macrophage-Stimulating Protein Receptor; Protein-Tyrosine Kinase 8; MST1R Variant RON30; MST1R Variant RON62; RON Variant E2E3; RON 30 Variant 21; CD136 Antigen; EC 2.7.10; CD136, all in membrane bound form. Accession numbers for the gene and protein are NC_000003.12; NT_022517.19; NC_018914.2; NP_001231866.1; NP_002438.2. The accession numbers are primarily given to provide a further method of identification of MST1R as a target, the actual sequence of the MST1R protein bound by an antibody may vary, for 2023222928 31 Aug 2023 instance because of a mutation in the encoding gene such as those occurring in some cancers or the like. The MST1R antigen binding site binds MST1R and a variety of variants thereof, such as those expressed by some MST1R positive tumor cells. 5 The invention also provides a monospecific antibody comprising variable domains that bind LGR4 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5777 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5777 as depicted in Figure 1 having 10 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides a monospecific antibody comprising variable 15 domains that bind LGR4 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5781 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5781 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 20 respect said VH. The invention also provides a monospecific antibody comprising variable domains that bind LGR5 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5790 as depicted in Figure 1; or 25         - the amino acid sequence of VH chain MF5790 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 30          The invention also provides a monospecific antibody comprising variable domains that bind LGR5 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5803 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5803 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 2023222928 31 Aug 2023 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides a monospecific antibody comprising variable 5 domains that bind LGR5 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5814 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5814 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 10 respect said VH. The invention also provides a monospecific antibody comprising variable domains that bind LGR5 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5816 as depicted in Figure 1; or 15         - the amino acid sequence of VH chain MF5816 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 20          The invention also provides a monospecific antibody comprising variable domains that bind LGR5 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5817 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5817 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 25   5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides a monospecific antibody comprising variable domains that bind LGR5 wherein the VH chain of the variable domains comprises 30         - the amino acid sequence of VH chain MF5818 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5818 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 2023222928 31 Aug 2023 The invention also provides a monospecific antibody comprising variable domains that bind RNF43 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5832 as depicted in Figure 1; or 5         - the amino acid sequence of VH chain MF5832 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 10          The invention also provides a monospecific antibody comprising variable domains that bind RNF43 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5836 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5836 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 15   5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides a monospecific antibody comprising variable domains that bind ZNRF3 wherein the VH chain of the variable domains comprises 20         - the amino acid sequence of VH chain MF5850 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5850 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 25 The invention also provides a monospecific antibody comprising variable domains that bind ZNRF3 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5853 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5853 as depicted in Figure 1 having 30 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 2023222928 31 Aug 2023 The invention also provides a monospecific antibody comprising variable domains that bind ZNRF3 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5855 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5855 as depicted in Figure 1 having 5 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. The invention also provides a monospecific antibody comprising variable 10 domains that bind ZNRF3 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5884 as depicted in Figure 1; or - the amino acid sequence of VH chain MF5884 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with 15 respect said VH. The invention also provides a monospecific antibody comprising variable domains that bind ZNRF3 wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF5888 as depicted in Figure 1; or 20         - the amino acid sequence of VH chain MF5888 as depicted in Figure 1 having at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 25         In one embodiment the invention a monospecific antibody comprising variable domains that bind EGFR wherein the VH chain of the variable domains comprises - the amino acid sequence of VH chain MF3755 as depicted in Figure 1; or - the amino acid sequence of VH chain MF3755 as depicted in Figure 1 having 30 at most 15, preferably 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 and preferably having 1, 2, 3, 4 or 5 amino acid insertions, deletions, substitutions or a combination thereof with respect said VH. 2023222928 31 Aug 2023 The invention relates to an antibody that comprises a variable domain that can bind an epitope on an extracellular part of LGR5 which epitope is located within amino acid residues 21-118 of SEQ ID NO: 1 depicted in figure 39. It was shown that amino acid residues D43; G44, M46, F67, G90, and F91 are involved in binding of 5 the antibody. Involved in does not necessarily mean that all residues are indeed contacted by the antibody. Without being bound by theory it is believed that the substitution D43A or G44A results in a (slight) conformational change in the epitope and that the conformation change results in reduced binding of the antibody to the epitope. 10 The interaction of the antibody with LGR5 does not inhibit the binding of RSPO 1 to LGR5 expressed on the membrane of an LGR5-expressing cell. The interaction of the antibody with RSPO 1 does not inhibit the binding of the antibody to LGR5 expressed on the membrane of an LGR5-expressing cell. This means that 15 the antibody and RSPO1 do not compete with each other for binding to LGR5. At least not in the range of molar ratio’s indicated herein. The molar ratio of antibody to RSPO 1 it typically from 0,1 to 0,001 (inclusive) preferably in a molar ratio of between 0,1 to 0,01 (inclusive). In this range the binding of the antibody to LGR5 does not inhibit (block) the binding of RSPO 1 to LGR5. 20 When herein molar ratio’s of antibody to RSPO are mentioned it is preferred that the antibody is present in amounts that result in 40%-80% of the binding achieved when saturating amounts of the antibody are present. 25         Various antibodies that bind to LGR5 have been described. Binding of an antibody to LGR5 can block the binding of an Rspondin to LGR5 or not. It has been found that antibodies that block the binding of Rspondin 1 ligand to LGR5 bind to a region encompassing the N-terminal region, Leucine-rich repeat (LRR) region 1 and LRR2 of the protein (Lau et al 2011; Nature vol 476; pp 293-297 and supplemental 30 information described therein). The elements are contained in amino acids 21-118 (inclusive) of an LGR5 protein sequence as depicted in SEQ ID NO: 1 depicted in figure 39; wherein amino acids 21-70 constitute the N-terminal region, amino acids 71-94 (inclusive) constitute LRR1 and 95-118 constitute LRR2. Only few antibodies that do not block the interaction of LGR5 with Rspondin 1 have been reported in the 2023222928 31 Aug 2023 art and to the best of the inventor’s knowledge none of these bind to the N-terminal region of LGR5. The invention now provides a protein that binds to an epitope within amino 5 acid residues 21-118 of an LGR5 sequence of SEQ ID NO: 1 depicted in figure 39 and which protein does not block the binding of Rspondin 1 to LGR5. The test for determining whether an antibody blocks or does not block the binding of an Rspondin to LGR5 preferably incudes CHO cells that express LGR5 on 10 the cell membrane. The antibody and the Rspondin to be analyzed are mixed together and added to the cells whereupon the binding of the antibody to the cells is determined. The amount of binding of the antibody to the LGR5 expressing cells in the presence of an excess of Rspondin indicates that the antibody does not block the binding of Rspondin to LGR5. The test preferably further includes a control antibody 15 that binds LGR5 and that blocks the binding of the Rspondin to LGR5. The control antibody is preferably antibody PB10261 or OMP88R20 as described in as described in the examples A protein does not block the binding of Rspondin 1 to LGR5 if, under otherwise the same conditions, more protein when compared to control antibody can bind to LGR5 expressing cells. This is preferably assessed under conditions wherein 20 the molar ratio of protein or control antibody to Rspondin is 1:10 or less, i.e. 0,1 or less; preferably in a molar ratio of between 0,1 to 0,001, (inclusive), preferably 0,1 to 0,01 (inclusive). The protein preferably also binds an extracellular part of another membrane associated protein. In a preferred embodiment the other membrane associated protein is a membrane associated member of the EGF-receptor family or 25 cMET. The invention also provides a protein that can bind an epitope on an extracellular part of LGR5 which epitope is located within amino acid residues 21118 of SEQ ID NO: 1 depicted in figure 39 and wherein the binding of the protein to 30 LGR5 is reduced with one or more of the following amino acid residue substitutions D43A; G44A, M46A, F67A, G90A, and F91A. In a preferred embodiment the interaction of Rspondin (RSPO) 1 with LGR5 on an LGR5-expressing cell does not inhibit the binding of the protein to LGR5 by more than 20%. The inhibition of binding of the protein to LGR5 is preferably measured when the protein and the 2023222928 31 Aug 2023 RSPO 1, 2, 3 or 4 are present in a molar ratio of 0,1 or less; preferably in a molar ratio of between 0,1 to 0,001, (inclusive), preferably 0,1 to 0,01 (inclusive) (protein:RSPO). 5         The invention further provides a protein that can bind an epitope on LGR5 that is located within amino acid residues 21-118 of SEQ ID NO: 1 depicted in figure 39, and wherein interaction of RSPO 1 with LGR5 on an LGR5-expressing cell does not inhibit the binding of the protein to LGR5 by more than 20% when the protein and the RSPO 1 are present in a molar ratio from 0,1 or less; preferably in a molar 10 ratio of between 0,1 to 0,001, (inclusive), preferably 0,1 to 0,01 (inclusive). The epitope is preferably located within amino acid residues 40-95 of SEQ ID NO: 1 depicted in figure 39. The binding of the protein to LGR5 is preferably reduced with one or more of the following amino acid residue substitutions D43A; G44A, M46A, F67A, G90A, and F91A. This typically indicates that the protein interacts with these 15 mentioned amino acids. Changing these amino acids these alters the binding of the protein to LGR5. These amino acids are therefore likely to be the contact residues in LGR5 for the binding protein. In the present case the inventors consider residues M46; F67, G90A and F91 to be contact residues. D43 and G44 can also be contact residues but can also be residues that alter the specific conformation of other 20 residues such that they are no longer able to be bound by the protein. The protein preferably can bind a further protein. The further protein is preferably a membrane protein comprising an extracellular part. The further protein is preferably a membrane associated member of the epidermal growth factor (EGF) receptor family or cMET. The LGR5 binding protein as discussed herein is preferably an antibody 25 preferably a bispecific antibody. The invention further provides a bispecific antibody comprising a variable domain that can bind an epitope on an extracellular part of LGR5 which epitope is located within amino acid residues 21-118 of SEQ ID NO: 1 depicted in figure 39 and 30 wherein the binding of the variable domain to LGR5 is reduced with one or more of the following amino acid residue substitutions D43A; G44A, M46A, F67A, G90A, and F91A; the bispecific antibody further comprises a variable domain that can bind a further protein. The further protein is preferably a membrane protein comprising an 2023222928 31 Aug 2023 extracellular part. The further protein is a membrane associated member of the EGF receptor family or cMET. The binding of the protein or bispecific antibody as mentioned herein to the 5 membrane associated member of the EGF receptor family or cMET preferably reduces ligand-induced signaling in a cell that comprises said membrane associated member of the EGF receptor family or cMET. The invention provides an antibody that comprises a variable domain that 10 can bind an epitope on an extracellular part of LGR5 which epitope is located within amino acid residues 21-118 of SEQ ID NO: 1 depicted in figure 39. The invention further provides an antibody that binds an epitope on an extracellular part of LGR5, wherein amino acid residues D43; G44, M46, F67, G90, 15 and F91 are involved in binding of the antibody to the epitope. The invention further provides an antibody that binds an epitope on an extracellular part of LGR5, wherein one or more of the amino acid residue substitutions of D43A; G44A, M46A, F67A, G90A, and F91A reduces the binding of 20 the antibody to the epitope. The invention further provides an antibody that comprises a variable domain that can bind an epitope on an extracellular part of LGR5 which epitope is located within amino acid residues 21-118 of SEQ ID NO: 1 depicted in figure 39, and 25 wherein the binding of the antibody to the epitope is reduced by one or more of the following amino acid residue substitutions D43A; G44A, M46A, F67A, G90A, and F91A. A membrane protein as used herein is a cell membrane protein, i.e. a protein 30 that is in the outer membrane of a cell, the membrane that separates the cell from the outside world. The membrane protein has an extracellular part. A membrane protein is at least on a cell if it contains a transmembrane region that is in the cell membrane of the cell. 2023222928 31 Aug 2023 The antibody preferably further comprises a further variable domain can bind a further protein. The further protein is preferably a membrane protein comprising an extracellular part. The further protein is preferably a membrane associated member of the epidermal growth factor (EGF) receptor family or cMET. The antibody 5 is a bispecific antibody. For the purpose of clarity and a concise description features are described herein as part of the same or separate embodiments, however, it will be appreciated that the scope of the invention may include embodiments having 10 combinations of all or some of the features described. BRIEF DESCRIPTION OF THE DRAWINGS Figure 1: amino acid sequences of VH fragments described in the current 15 application. CDR1, CDR2 and CDR3 regions, as well as FR1, FR2, FR3 and FR4 regions are indicated. Figure 2: nucleotide sequences of selected VH-encoding cDNA’s described in the current application. 20 Figure 3: Annotated sequence of the common light chain (cLC). Figure 4: Annotated Fc (CH1-CH3) region amino acid sequence of antibodies tested in the present application. 25 Figure 5: The effect of growth factors EGF and HRG on the tumoroid morphology in tumoroids P14T and P18T. Example of the effect of growth factors EGF and HRG on the tumoroid morphology 30 in tumoroids P14T and P18T. Growth factors induce a simultaneous change in tumoroid size, the lumen size and the distribution of the lumen. The combination of these three morphological parameters locates the observed organoids in a unique feature space. The Euclidian distance can be calculated based on the combination of these three features with the no growth factor (no GF) as a reference point. The 2023222928 31 Aug 2023 Euclidian distance is then the change in X, Y and Z direction induced by the treatments. Figure 6: FACS analysis of sera of ZNRF3-immunised animals binding to Freestyle 5   293F cells that stably over-expressed the antigen, taken at day 35. Sera were tested compared to the day 0 (pre-immune) sera for binding to the 293F Freestyle cell line stably expressing the ECD of ZNRF3. Every panel shows an overlay of control (non-stained) cells (filled grey) and the cells stained with the 10 respective sera (no fill). Mice are numbered L19-L24; control stainings are indicated on the right side of the figure n.c.: negative control. Figure 7: Example of FACS staining of a mix of DiD-labelled ZNRF3 overexpressing cells and non-labelled (parental) 293F freestyle cells using preparations 15 of selected monoclonal phage clones. Every dot-plot is an overlay of non-stained cells and cells stained with a selected Fab expressed on phage. The upper half of every panel shows the DiD-labelled antigenpositive cells and the lower half of the panel the non-labelled antigen-negative 293F 20 freestyle cells. Of the six clones shown in the figure (labelled 1-6), four are antigenspecific (1, 3, 4 and 6) and two (2 and 5) are non-reactive. Control for expression of the protein was staining with the antibody directed to the cMyc-derived epitope tag and negative control was staining with the secondary antibodies (anti-M13 and Strep-PE) only. 25 Figure 8: Affinity ranking of monovalent IgG directed to hLGR5 (all combined with the Tetanus toxoid Fab Fragment) on the cellular surface of Freestyle 293F cells overexpressing hLGR5. 30 A representative example of the entire panel is shown. A two-fold dilution series of IgG (5gg / ml — 0,08gg / ml) was tested on a fixed number of cells (5x105 cells / well) stable expressing hLGR5. The mean fluorescence intensity (MFI) was measured for each data point and was plotted against the increasing amount of IgG used for staining. From each IgG the area under the curve (AUC) was calculated based on 2023222928 31 Aug 2023 a the individual curves and used for ranking. The table (right panel) shows the AUC values of bispecific IgG shown in the graph (left panel). Based on the AUC values the IgG were ranked for binding affinity to their respective target. 5 Figure 9: rhR-Spondin3 blocking capacity of hLGR5 monovalent binding IgG (all combined with a TT Fab fragment) was tested in an R-Spondin blocking ELISA. A representative example is shown of the LGR5 panel. Maximum binding (normalized to 0%) was established by uninhibited binding to 2gg / ml coated rhR-10 Spondin3 using 0,031gg / ml rhLGR5-Fc, and detection with an anti-Fc antibody. The OD450nm value for maximum binding was set at 100%. R-Spondin3 surplus indicates the addition of excess R-Spondin3 (15pg / ml) to serve as a positive control for competition. The bispecific IgG, tested at 15gg / ml, the OD450nm values were normalized based on the maximum signal and are indicated by the blue bars. Clones 15 were considered partially blocking when the percentage was below 80% and considered blocking when the percentage was below 50%. This example shows a representative panel of LGR5 targeting LGR5 / TT IgG fragments. Figure 10: Growth inhibiting effects of the reference antibody PG3755 (EGFR 20 bivalent, mono-specific) and PB10651 (EGFR / LGR5 bispecific) on the tumoroid line P18T in the presence of 5ng / ml EGF in the culture medium. The antibodies revert the EGF-induced tumoroid phenotype to a no growth factor stimulated phenotype (first column). PB10651 is active as a growth inhibitor at lower 25 doses than the EGFR bispecific reference antibody PG3755. Figure 11: Example of the validation screen results for one colon tumoroid exposed to EGFR / WNT targeting bispecific antibodies and control treatments. 30 The lower the Euclidian distance, the more potent the treatment effect; 1 equals normal growth. PB10651 (EGFR / LGR5 antibody with MF3755xMF5816) shows complete growth inhibition at the dose tested (2gg / ml) and outperforms Cetuximab. Figure 12: PB10651 retains immune-reactivity after labelling with 125I. 2023222928 31 Aug 2023 Immuno-reactivity of radio-active labelled protein. A: Lindmo assay for the anti-EGFR Fab arm in PB10651; B: Lindmo assay for the anti-LGR5 Fab arm of PB10651. There was very little loss of immune-reactivity after labelling of the protein with 125I. 5 Figure 13: PB10651 binds with sub-nanomolar affinity to both EGFR and LGR5. Affinity analysis of PB10651 binding to LGR5 and EGFR. A: analysis of PB10651 binding to CHO-LGR5 cells; B: analysis of PB10651 binding to CHO-EGFR cells and C: affinity analysis of PB10651 binding to DLD-1 cells. 10 Figure 14: The anti-EGFR Fab arm in PB10651 binds to residues in domain III of EGFR as determined by shotgun mutagenesis analysis. The epitope on EGFR recognised by the anti-EGFR Fab arm present in PB10651 is depicted, modelled onto the structure of EGFR (Li et al., 2005; pdb reference 1YY9). Residues that were found to be relevant for the binding of PB10651 are highlighted 15 in the structure. Figure 15: The anti-LGR5 Fab arm in PB10651 binds to residues present in the N-CAP domain and first leucine-rich repeat of LGR5, as determined by shotgun mutagenesis analysis. 20 The figure shows the epitope on LGR5 recognised by PB10651, modelled onto the structure of LGR5 in complex with RSPO1 (Peng et al., 2013: pdb reference 4BSR). The residues that are recognised are indicated in black in the left (light grey) LGR5 molecule of the dimer. RSPO1 is indicated in ball and stick. 25 Figure 16: The copied version of the OMP88R20 anti-LGR5 antibody is dose-dependently inhibited for binding LGR5 by the ligand R-spondinl. The copied version of OMP88R20 (PG7711) was tested for binding at the EC50 (50ng / ml) for binding to LGR5 over-expressing cells in the presence of increasing amounts of R-spondinl. The MFI value obtained was normalised to the control (no 30 R-spondinl) value. Figure 17: The anti-LGR5 Fab MF5816 present in PB10651 is not inhibited for binding LGR5 in a large molar excess of the ligand R-spondinl. 2023222928 31 Aug 2023 The copied version of OMP88R20 (PG7711) was tested for binding at 50ng / ml and bispecifics were tested at lOOng / ml for binding to LGR5 over-expressing cells in the presence of increasing concentrations of R-spondinl, or of the rat antibody 1D9. Binding of the indicated antibodies was detected with a PE-labeled anti-human IgG 5 secondary antibody. For every point in the curve, the MFI value obtained was normalised to (divided by) the value found in the control (no R-spondinl) situation. Figure 18: Bivalent, mono-specific PG3755 potently inhibits EGFR-mediated signalling. 10 The proliferation (measured as fluorescence counts after alamar blue addition to the cells: Y-axis) of A431 cells was measured in the presence of 62.5ng / ml of human EGF and increasing amounts of the indicated anti-EGFR antibodies. PG1337 served as non-binding (negative) control. An increasing number of counts is indicative of an increased number of cells and thereby of blocking EGFR-mediated signalling. 15 Figure 19: Afucosylated PB10651 binds with comparable affinity to the cynomolgus orthologues of both EGFR and LGR5. MFI values obtained after staining with the indicated antibody at the indicated concentration in FACS are depicted as a function of the concentration of antibody 20 used. For EGFR, cetuximab was used as positive control for cynomolgus EGFR binding. For LGR5, the copied version of hu8Ellv2 (PG7543) from Genentech was used as positive control for cynomolgus LGR5 binding. Figure 20: Staining of patient-derived organoids in FACS using lead anti-25 LGR5 / EGFR bispecific antibodies visualises LGR5 expression. An organoid sample derived from a colorectal cancer patient (Pl8) was stained using two different anti-LGR5 antibodies (MF5816 and MF5814) and a negative control that recognizes Tetanus Toxin (TT). The staining of the TT antibody was used to set the threshold for the staining of the two anti-LGR5 antibodies. With the TT staining 30 set at 0.8%, the MF5816 and MF5814 antibodies showed comparable staining levels with 53.6% and 52.7% of the cells scored positive for LGR5 expression. 2023222928 31 Aug 2023 Figure 21: Staining and sorting of patient-derived organoids using lead bispecific anti-LGR5 / EGFR bispecific antibodies enriches for LGR5-expressing (cancer stem) cells. 5 A colorectal cancer organoid line (P18T) was used for FACS staining and sorting of the top (positive) and bottom (negative) 15% of stained cells identified by the anti-LGR5 antibodies MF5814 and MF5816. 2000 single cells were sorted for each population and used to generate cDNA for quantitative PCR. The expression of B2M was used as an endogenous control, and the expression of the LGR5 mRNA in the 10 positive fraction was represented relative to the negative fraction using the 2—AACT method and the StepOne 2.2 plus software. The experiment was ran on two separate occasions (Exp.l and Exp. 2), with each antibody, and experimental repeats, displaying an increase in LGR5 mRNA in the positive fraction relative to the negative. Error bars represent the relative quantification max, which was produced 15 as part of the analysis using the StepOne 2.2 plus software. Figure 22: Sorting of patient-derived organoid for LGR5-expressing cells using lead anti-LGR5 / EGFR bispecific antibody enriches for tumour-initiating cells. 20   Left: pictures of the organoids depict one of the BME drops and were captured using an Olympus MVX10 MacroView microscope. The inset on the MF5816 picture displays a closer view of one of the organoids in the drop. Right: bar graph depicting the number of organoids counted after two weeks of growth found in the LGR5-positive and -negative cell population. 25 Figure 23: Treatment of patient-derived organoids with lead anti-LGR5 / EGFR bispecific antibody potently inhibits organoid outgrowth. Left: bar graphs depicting the average organoid number (top) and organoid size 30 (bottom) found after the different treatments with the indicated antibodies (indicated below the graphs). Right: representative examples of images obtained from the organoids after the different treatments. Single cells were seeded and left to establish organoids for three days. On day three the media was removed and replaced with media containing the antibodies at a concentration of 2gg / mL. The 2023222928 31 Aug 2023 organoids were further cultured for another 7 days. On day 7 the organoids were scanned using an Olympus ScanR using the x4 light objective, and the number of organoids quantified using ImageJ running an in-house designed macro. The data is presented relative to the TT control, and a two-tailed, paired sample T-Test was run 5 to assess for significant differences between treatments. Error bars represent standard deviation. *=p<0.05 relative to TT, **=p<0.001 relative to TT. #= p<0.05 relative to EGFR-TT, ##= p<0.001 relative to EGFR-TT. Figure 24: LGR5xEGFR bispecifics potentiate the reduction of the non-10 differentiated cell population Single cells were seeded and grown for three days before being treated with the antibodies. After seven days, total RNA was extracted and used for quantitative realtime PCR analysis to detect the mRNA levels of LGR5 and CK20 (a marker of differentiation). Differences in expression were detected using the 2—AACT method. 15 The data is presented relative to the negative control (TT-TT). The experiment was carried out on two separate occasions, and the average of the two experiments shown. Error bars represent the standard deviation of the two experiments. Figure 25: Examples of superclusters indicating amino acid changes that are 20   tolerated in a VH and / or CDR therein of the present invention without losing binding specificity. Figure 26: Comparison of the potency of PB10651 versus Cetuximab in inhibiting growth of patient-derived tumoroids and organoids derived from normal tissue in 25 vitro Examples of the effects of treatments with concentrations ranges of PB10651 and Cetuximab on organoid cultures from organoids derived from normal tissue and from cancerous tissue (A and B). Figure 26C: IC50 values for growth inhibition obtained using patient-derived tumoroids and organoids derived from normal tissue. The ratio 30 in the third column depicts the ratio IC50(Cetuximab) / IC50(PB10651). Figure 27: PB10651 is significantly more potent than monospecific anti-EGFR and anti-LGR5 antibodies in inhibiting organoid growth in vitro. 2023222928 31 Aug 2023 In vitro treatment of pl8T (A) and C1M (B) organoid cultures in 3D with the indicated antibodies. Organoid size is plotted as a function of the concentration of antibody used. Anti-LGR5 antibodies do not show any effects on organoid growth; 5 Figure 28: PB10651 is more potent in reducing organoid growth in vitro than a mix of the parental bivalent, mono-specific antibodies. The figure shows growth inhibiting effects of the reference antibodies PG3755 (EGFR bivalent, mono-specific), PG5816 (LGR5 bivalent, mono-specific) or an equimolar combination thereof and PB10651 (EGFR / LGR5 bispecific) on the 10 tumoroid line P18T in the presence of EGF. A. P18T organoid size is depicted as a function of antibody concentration used for treatment. Organoids treated with PG5816 showed no growth inhibition; PG3755 significantly reduced growth, but not to the same extent as PB10651. The combination of PG3755 and PG5816 was also significantly less potent than PB10651 in inhibiting growth of P18T tumoroids. B. A 15 comparison of the IC 50 values for growth inhibition found for treatment of the indicated organoids (top) with the indicated antibodies (left panel). The IC50 values found for PB10651 are always lower than those found for the mix of the parental antibodies. 20 Figure 29: In vitro organoid treatment with PB10651 causes intra-cellular localisation of antibody that is not observed with monospecific, bivalent antibodies directed to LGR5 or EGFR. After 24 hours of antibody treatment, organoids were fixed, permeabilised and stained for human IgG to reveal (sub-) cellular localisation of antibody. Only in the 25 case of PB10651, a punctate intra-cellular staining was observed that was absent in the organoids treated with bivalent, mono-specific antibodies. In the latter case, antibody was concentrated and localised onto the cell membrane. Figure 30: Organoids that are responsive to treatment with PB10651 show intra-30 cellular localisation of antibody that is not observed after treatment of organoids that are not responsive to the treatment. After 24 hours of antibody treatment, organoids were fixed, permeabilised and stained for human IgG to reveal (sub-) cellular localisation of antibody. The different organoids that were responsive to treatment with PB10651 (COM, C55T, P18T, 2023222928 31 Aug 2023 C31M) showed intra-cellular staining of antibody, whereas the organoids that were non-responsive showed cell surface localisation of PB10651 (C28T, P19Tb, P8T, C51N). 5 Figure 31: Vector maps of MV1453 and MV1626 plasmids. Figure 32: Vector map of MV1622 (RMD expression vector). Figure 33: CEX-HPLC profile of afucosylated PB10651. 10 Figure 34: Results of the ADCC reporter assay of PB10651(ADCC-enhanced) compared to PB10651(non-enhanced) and PG1337 (control). Figure 35: Expression of EGFR and LGR5 in patient-derived xenograft (PDX) 15 models. Expression of EGFR and LGR5 genes in live study and frozen stock tumors was measured by TaqMan real time PCR. Expression is represented as the log-transformed value obtained with the 2—AACT method, using GAPDH as housekeeping gene. Tumors extracted from live animals presented gene expression 20 values similar to the reference stock tumors. Figure 36: PB10651 inhibits the in vivo growth of PDX. The colorectal PDX models were treated weekly (arrows) with PB10651 or Cetuximab or PBS. Tumor growth (indicated in mm3) was followed during and after 25 cessation of the treatment. Models responsive to cetuximab (one WT and one KRAS G13D mutant) also responded to PB10651. One out of three KRAS G12V / D mutant models that did not respond to Cetuximab displayed significant tumor growth inhibition with PB10651. 30 Figure 37: Treatment with PB10651 causes a significant reduction in the number of proliferating cells in the tumour. Immunohistochemical Staining of P18 Tumoroids After 48 Hours of Treatment (2 gg / mL). The top panel depicts a marker of proliferation (ki67), and the lower panel a marker of apoptosis (cleaved caspase-3). Images were taken using using a x20 2023222928 31 Aug 2023 objective, brown staining indicates expression, with nuclei counter stained using haematoxylin Figure 38: PB10651 is significantly more potent than cetuximab in inhibiting 5 organoid growth in vivo. A The Effect of Weekly Antibody Dosing on P18 Xenograft Growth. Once tumours reached an average size of 50 mm3 antibody treatments began (day 0) and the relative change in volume is plotted. Mice were treated once a week (indicated by arrows). All tumour volumes within a treatment group were averaged 10 and plotted; the number of xenografts at each time point is represented in the table. Error bars represent the standard error of the mean. *=P<0.01 compared to PBS, #=P<0.01 compared to cetuximab as determined by paired t-test analysis. B. The Effect of Weekly Antibody Dosing on C3IM Xenograft Growth. Once tumours reached an average size of 30 mm3 antibody treatments began (day 0) 15 and the relative change in volume is plotted. Mice were treated once a week (indicated by arrows). All tumour volumes within a treatment group were averaged and plotted; the number of xenografts at each time point is represented in the table. Error bars represent the standard error of the mean. *=P<0.01 compared to PBS, #=P<0.05 compared to cetuximab as determined by paired t-test analysis 20 Figure 39: Annotated amino acid sequence of human LGR5. Leader indicates the amino acid sequence that is cut from the mature protein, the N-region spans amino acids 21-70 inclusive; LRR stands for leucine-rich repeat region, LLR1 is leucine-rich repeat region 1; LRR2 is leucine-rich repeat region 2 etc. 25 LLR1 starts at amino acid 71 and ends at amino acid 94 (inclusive); LLR2 starts at 95 and ends at 118 inclusive. CRL is the cysteine rich linker region. TM indicates the various transmembrane regions and C-TERM the c-terminal end of the protein. The annotated parts together form one consecutive sequence designated SEQ ID NO: 1. This complete sequence is SEQ ID NO: 1 this numbering prevails even if for some 30 reason another sequence is also listed as SEQ ID NO: 1. Figure 40: Annotated amino acid sequence of wild type, human EGFR (GenBank NM_005228). 2023222928 31 Aug 2023 The signal peptide, extra-cellular part, predicted trans-membrane helix and intracellular tyrosine kinase including the C-terminal tail are all indicated. The annotated parts together form one consecutive sequence designated SEQ ID NO: 2. This complete sequence is SEQ ID NO: 2 this numbering prevails even if for some 5 reason another sequence is also listed as SEQ ID NO: 2. Examples As used herein “MFXXXX” wherein X is independently a numeral 0-9, refers to a Fab comprising a variable domain wherein the VH has the amino acid 10 sequence identified by the 4 digits. Unless otherwise indicated the light chain variable region of the variable domain typically has a sequence of Figure 3. The light chain has a sequence as depicted in Figure 3. “MFXXXX VH” refers to the amino acid sequence of the VH identified by the 4 digits. The MF further comprises a constant region of a light chain and a constant region of 15 a heavy chain that normally interacts with a constant region of a light chain. PG refers to a monospecific antibody comprising identical heavy and light chains. PB refers to a bispecific antibody with two different heavy chains. The VH I variable region of the heavy chains differs and typically also the CH 3 region, wherein one of the heavy chains has a KK mutation of its CH3 domain 20 and the other has the complementing DE mutation of its CH3 domain (see for reference PCT / NL2013 / 050294 (published as WO2013 / 157954). In PB, PG and other codes the numerical indication is sometimes followed by an indication of the production batch. For instance PB10651p06 refers to PB10651 batch 6. 25 Example: 1 Methods, Materials and Screening of Antibodies 30 Cell Lines: Freestyle 293F cells (cat. nr. p / n51-0029) were obtained from Invitrogen and routinely maintained in 293 FreeStyle medium. HEK293T (ATCC-CRL-11268) and 2023222928 31 Aug 2023 CHO-K1 (DSMZ ACC110) cell lines were purchased from ATCC and routinely maintained in DMEM / F12 (Gibco) supplemented with L-Glutamine (Gibco) and FBS (Lonza). 5 Generation of Recombinant human and mouse LGR4, LGR5, ZNRF3 and RNF43 expression vectors Human LGR4 Full length human (h)LGR4 was present in vector pEFl_Myc / His (Invitrogen), containing 2 FLAG tags and 2 HA tags (pEFl_hLGR4-FLAG-HA), and was cloned into pVaxl (Invitrogen), resulting in pVaxl_hLGR4-FLAG-HA. The 10 insert sequence was verified by comparison with the NCBI Reference sequence NM_018490. The sequence contained the following deviations on amino acid level: P2A in the signal peptide. The insert from construct pEFl_hLGR4-FLAG-HA was recloned into pVaxl. Alternative the full length hLGR4 in pVaxl was replaced with a truncated version of hLGR4; hLGR4(ECD)-GPA33(TM)-FLAG resulting in 15 pVaxl_hLGR4(ECD)-GPA33(TM)-FLAG. Amino acid sequence full length hLGR4-FLAG-HA insert (both in pEFl_Myc / His and pVaxl) for expression on cell surface MAGPLGLLCFLALGLLGSAGPSGAAPPLCAAPCSCDGDRRVDCSGKGLTAVPEGLSAFTQALDISM 20 NNITQLPEDAFKNFPFLEELQLAGNDLSFIHPKALSGLKELKVLTLQNNQLKTVPSEAIRGLSALQS LRLDANHITSVPEDSFEGLVQLRHLWLDDNSLTEVPVHPLSNLPTLQALTLALNKISSIPDFAFTNL SSLWLHLHNNKIRSLSQHCFDGLDNLETLDLNYNNLGEFPQAIKALPSLKELGFHSNSISVIPDGA FDGNPLLRTIHLYDNPLSFVGNSAFHNLSDLHSLVIRGASMVQQFPNLTGTVHLESLTLTGTKISSI PNNLCQEQKMLRTLDLSYNNIRDLPSFNGCHALEEISLQRNQIYQIKEGTFQGLISLRILDLSRNLI 2 5  HEIHSRAFATLGPITNLDVSFNELTSFPTEGLNGLNQLKLVGNFKLKEALAAKDFVNLRSLSVPYA YQCCAFWGCDSYANLNTEDNSLQDHSVAQEKGTADAANVTSTLENEEHSQIIIHCTPSTGAFKPCE YLLGSWMIRLTVWFIFLVALFFNLLVILTTFASCTSLPSSKLFIGLISVSNLFMGIYTGILTFLDAVSW GRFAEFGIWWETGSGCKVAGFLAVFSSESAIFLLMLATVERSLSAKDIMKNGKSNHLKQFRVAALL AFLGATVAGCFPLFHRGEYSASPLCLPFPTGETPSLGFTVTLVLLNSLAFLLMAVIYTKLYCNLEKE 30 DLSENSQSSMIKHVAWLIFTNCIFFCPVAFFSFAPLITAISISPEIMKSVTLIFFPLPACLNPVLYVFF NPKFKEDWKLLKRRVTKKSGSVSVSISSQGGCLEQDFYYDCGMYSHLQGNLTVCDCCESFLLTKP VSCKHLIKSHSCPALAVASCQRPEGYWSDCGTQSAHSDYADEEDSFVSDSSDQVQACGRACFYQS RGFPLVRYAYNLPRVKDSRDYKDDDDKAGADYKDDDDKLDGGYPYDVPDYAAGAYPYDVPDYA 2023222928 31 Aug 2023 Of which: MAGPLGLLCFLALGLLGSAGPSGA: signal peptide APPLCAAPCSCDGDRRVDCSGKGLTAVPEGLSAFTQALDISMNNITQLPEDAFKNFPFLEELQLAG 5 NDLSFIHPKALSGLKELKVLTLQNNQLKTVPSEAIRGLSALQSLRLDANHITSVPEDSFEGLVQLRH LWLDDNSLTEVPVHPLSNLPTLQALTLALNKISSIPDFAFTNLSSLWLHLHNNKIRSLSQHCFDGL DNLETLDLNYNNLGEFPQAIKALPSLKELGFHSNSISVIPDGAFDGNPLLRTIHLYDNPLSFVGNSA FHNLSDLHSLVIRGASMVQQFPNLTGTVHLESLTLTGTKISSIPNNLCQEQKMLRTLDLSYNNIRD LPSFNGCHALEEISLQRNQIYQIKEGTFQGLISLRILDLSRNLIHEIHSRAFATLGPITNLDVSFNELT 10 SFPTEGLNGLNQLKLVGNFKLKEALAAKDFVNLRSLSVPYAYQCCAFWGCDSYANLNTEDNSLQD HSVAQEKGTADAANVTSTLENEEHSQIIIHCTPSTGAFKPCEYLLGSWMIRLTVWFIFLVALFFNLL VILTTFASCTSLPSSKLFIGLISVSNLFMGIYTGILTFLDAVSWGRFAEFGIWWETGSGCKVAGFLAV FSSESAIFLLMLATVERSLSAKDIMKNGKSNHLKQFRVAALLAFLGATVAGCFPLFHRGEYSASPL CLPFPTGETPSLGFTVTLVLLNSLAFLLMAVIYTKLYCNLEKEDLSENSQSSMIKHVAWLIFTNCIF 15 FCPVAFFSFAPLITAISISPEIMKSVTLIFFPLPACLNPVLYVFFNPKFKEDWKLLKRRVTKKSGSVS VSISSQGGCLEQDFYYDCGMYSHLQGNLTVCDCCESFLLTKPVSCKHLIKSHSCPALAVASCQRPE GYWSDCGTQSAHSDYADEEDSFVSDSSDQVQACGRACFYQSRGFPLVRYAYNLPRVKD: hLGR4 (FL) SR: linker region 20 DYKDDDDK: FLAG tag AGA: linker region DYKDDDDK: FLAG tag LDGG: Linker region YPYDVPDYA: HA tag 25 AGA: Linker region YPYDVPDYA: HA tag Amino acid sequence hLGR4(ECD)-GPA33-FLAG insert in pVaxl for expression on cell surface: 30 MPGPLGLLCFLALGLLGSAGPSGAAPPLCAAPCSCDGDRRVDCSGKGLTAVPEG LSAFTQALDISMNNITQLPEDAFKNFPFLEELQLAGNDLSFIHPKALSGLKELK VLTLQNNQLKTVPSEAIRGLSALQSLRLDANHITSVPEDSFEGLVQLRHLWLDD NSLTEVPVHPLSNLPTLQALTLALNKISSIPDFAFTNLSSLWLHLHNNKIRSLS QHCFDGLDNLETLDLNYNNLGEFPQAIKALPSLKELGFHSNSISVIPDGAFDGN 2023222928 31 Aug 2023 PLLRTIHLYDNPLSFVGNSAFHNLSDLHSLVIRGASMVQQFPNLTGTVHLESLT LTGTKISSIPNNLCQEQKMLRTLDLSYNNIRDLPSFNGCHALEEISLQRNQIYQI KEGTFQGLISLRILDLSRNLIHEIHSRAFATLGPITNLDVSFNELTSFPTEGLNGL NQLKLVGNFKLKEALAAKDFVNLRSLSVPYAYQCCAFWGCDSYANLNTEDNSL 5 QDHSVAQEKGTADAANVTSTLENEEHSQIIIHCTPSTGAFKPCEYLLGSWMIR VALYVGIAVGWAALIIIGIIIYCCCCRGKDDNTEDKEDARPNREAYEEPPEQLRE LSREREEEDDYRQEEQRSTGRESPDHLDQDYKDDDDK Of which: 10 MPGPLGLLCFLALGLLGSAGPSGA: signal peptide APPLCAAPCSCDGDRRVDCSGKGLTAVPEGLSAFTQALDISMNNITQLPEDAFK NFPFLEELQLAGNDLSFIHPKALSGLKELKVLTLQNNQLKTVPSEAIRGLSALQ SLRLDANHITSVPEDSFEGLVQLRHLWLDDNSLTEVPVHPLSNLPTLQALTLAL 15 NKISSIPDFAFTNLSSLWLHLHNNKIRSLSQHCFDGLDNLETLDLNYNNLGEF PQAIKALPSLKELGFHSNSISVIPDGAFDGNPLLRTIHLYDNPLSFVGNSAFHNL SDLHSLVIRGASMVQQFPNLTGTVHLESLTLTGTKISSIPNNLCQEQKMLRTLD LSYNNIRDLPSFNGCHALEEISLQRNQIYQIKEGTFQGLISLRILDLSRNLIHEIH SRAFATLGPITNLDVSFNELTSFPTEGLNGLNQLKLVGNFKLKEALAAKDFVNL 20 RSLSVPYAYQCCAFWGCDSYANLNTEDNSLQDHSVAQEKGTADAANVTSTLEN EEHSQIIIHCTPSTGAFKPCEYLLGSWMIR: hLGR4(ECD) VALYVGIAVGWAALIIIGIIIYCCCCRGKDDNTEDKEDARPNREAYEEPPEQLRE LSREREEEDDYRQEEQRSTGRESPDHLDQ: GPA33 sequence containing the TM region 25 DYKDDDDK: FLAG HumanLGR5 Full length human (h)LGR5 was present in vector pEFl_Myc / His (pEFl_hLGR5-30 FLAG-HA), containing 2 FLAG tags and 2 HA tags, and was cloned into pVaxl (Invitrogen), resulting in pVaxl_hLGR5-FLAG-HA. The sequence was verified by comparison with the NCBI Reference sequence NM_003667.3. The insert from construct pEFl_hLGR5-FLAG-HA was recloned into pVaxl, resulting in pVaxl_hLGR5-FLAG-HA. Alternative the full length hLGR5 in pVaxl was replaced 2023222928 31 Aug 2023 with a truncated version of hLGR5; hLGR5(ECD)-GPA33(TM)-FLAG resulting in pVaxl_hLGR5(ECD)-GPA33(TM)-FLAG. Amino acid sequence full length hLGR5-FLAG-HA insert (both in pEFl_Myc / His 5 and pVaxl) for expression on cell surface MDTSRLGVLLSLPVLLQLATGGSSPRSGVLLRGCPTHCHCEPDGRMLLRVDCSDLGLSELPSNLSV FTSYLDLSMNNISQLLPNPLPSLRFLEELRLAGNALTYIPKGAFTGLYSLKVLMLQNNQLRHVPTE ALQNLRSLQSLRLDANHISYVPPSCFSGLHSLRHLWLDDNALTEIPVQAFRSLSALQAMTLALNKI HHIPDYAFGNLSSLWLHLHNNRIHSLGKKCFDGLHSLETLDLNYNNLDEFPTAIRTLSNLKELGF 10 HSNNIRSIPEKAFVGNPSLITIHFYDNPIQFVGRSAFQHLPELRTLTLNGASQITEFPDLTGTANLES LTLTGAQISSLPQTVCNQLPNLQVLDLSYNLLEDLPSFSVCQKLQKIDLRHNEIYEIKVDTFQQLLS LRSLNLAWNKIAIIHPNAFSTLPSLIKLDLSSNLLSSFPITGLHGLTHLKLTGNHALQSLISSENFPEL KVIEMPYAYQCCAFGVCENAYKISNQWNKGDNSSMDDLHKKDAGMFQAQDERDLEDFLLDFEE DLKALHSVQCSPSPGPFKPCEHLLDGWLIRIGVWTIAVLALTCNALVTSTVFRSPLYISPIKLLIGVIA 15 AVNMLTGVSSAVLAGVDAFTFGSFARHGAWWENGVGCHVIGFLSIFASESSVFLLTLAALERGFSA KYSAKFETKAPFSSLKVIILLCALLALTMAAVPLLGGSKYGASPLCLPLPFGEPSTMGYMVALILLN SLCFLMMTIAYTKLYCNLDKGDLENIWDCSMVKHIALLLFTNCILNCPVAFLSFSSLINLTFISPEVI KFILLVWPLPACLNPLLYILFNPHFKEDLVSLRKQTYVWTRSKHPSLMSINSDDVEKQSCDSTQAL VTFTSSSITYDLPPSSVPSPAYPVTESCHLSSVAFVPCLARDYKDDDDKAGADYKDDDDKLDGGYP 20 YDVPDYAAGAYPYDVPDYA Of which: MDTSRLGVLLSLPVLLQLATG: signal peptide 25 GSSPRSGVLLRGCPTHCHCEPDGRMLLRVDCSDLGLSELPSNLSVFTSYLDLSMNNISQLLPNPLP SLRFLEELRLAGNALTYIPKGAFTGLYSLKVLMLQNNQLRHVPTEALQNLRSLQSLRLDANHISYV PPSCFSGLHSLRHLWLDDNALTEIPVQAFRSLSALQAMTLALNKIHHIPDYAFGNLSSLWLHLHN NRIHSLGKKCFDGLHSLETLDLNYNNLDEFPTAIRTLSNLKELGFHSNNIRSIPEKAFVGNPSLITI HFYDNPIQFVGRSAFQHLPELRTLTLNGASQITEFPDLTGTANLESLTLTGAQISSLPQTVCNQLPN 30 LQVLDLSYNLLEDLPSFSVCQKLQKIDLRHNEIYEIKVDTFQQLLSLRSLNLAWNKIAIIHPNAFSTL PSLIKLDLSSNLLSSFPITGLHGLTHLKLTGNHALQSLISSENFPELKVIEMPYAYQCCAFGVCENA YKISNQWNKGDNSSMDDLHKKDAGMFQAQDERDLEDFLLDFEEDLKALHSVQCSPSPGPFKPCE HLLDGWLIRIGVWTIAVLALTCNALVTSTVFRSPLYISPIKLLIGVIAAVNMLTGVSSAVLAGVDAFT FGSFARHGAWWENGVGCHVIGFLSIFASESSVFLLTLAALERGFSAKYSAKFETKAPFSSLKVIILL 2023222928 31 Aug 2023 90 CALLALTMAAVPLLGGSKYGASPLCLPLPFGEPSTMGYMVALILLNSLCFLMMTIAYTKLYCNLDK GDLENIWDCSMVKHIALLLFTNCILNCPVAFLSFSSLINLTFISPEVIKFILLVWPLPACLNPLLYIL FNPHFKEDLVSLRKQTYVWTRSKHPSLMSINSDDVEKQSCDSTQALVTFTSSSITYDLPPSSVPSPA YPVTESCHLSSVAFVPCL: hLGR5 5 AR: linker region DYKDDDDK: FLAG tag AGA: linker region DYKDDDDK: FLAG tag LDGG: linker region 10 YPYDVPDYA: HA tag AGA: linker region YPYDVPDYA: HA tag Amino acid sequence hLGR5(ECD)-GPA33(TM)-FLAG insert in pVaxl for expression on cell surface: 15 MDTSRLGVLLSLPVLLQLATGGSSPRSGVLLRGCPTHCHCEPDGRMLLRVDCS DLGLSELPSNLSVFTSYLDLSMNNISQLLPNPLPSLRFLEELRLAGNALTYIPKG AFTGLYSLKVLMLQNNQLRHVPTEALQNLRSLQSLRLDANHISYVPPSCFSGLH SLRHLWLDDNALTEIPVQAFRSLSALQAMTLALNKIHHIPDYAFGNLSSLWLH LHNNRIHSLGKKCFDGLHSLETLDLNYNNLDEFPTAIRTLSNLKELGFHSNNIR 20 SIPEKAFVGNPSLITIHFYDNPIQFVGRSAFQHLPELRTLTLNGASQITEFPDLTG TANLESLTLTGAQISSLPQTVCNQLPNLQVLDLSYNLLEDLPSFSVCQKLQKIDL RHNEIYEIKVDTFQQLLSLRSLNLAWNKIAIIHPNAFSTLPSLIKLDLSSNLLSSF PITGLHGLTHLKLTGNHALQSLISSENFPELKVIEMPYAYQCCAFGVCENAYKIS NQWNKGDNSSMDDLHKKDAGMFQAQDERDLEDFLLDFEEDLKALHSVQCSP 25 SPGPFKPCEHLLDGWLIRVALYVGIAVGWAALIIIGIIIYCCCCRGKDDNTEDKE DARPNREAYEEPPEQLRELSREREEEDDYRQEEQRSTGRESPDHLDQDYKDDD DK 30 Of which: MDTSRLGVLLSLPVLLQLATG: signal peptide GSSPRSGVLLRGCPTHCHCEPDGRMLLRVDCSDLGLSELPSNLSVFTSYLDLSM NNISQLLPNPLPSLRFLEELRLAGNALTYIPKGAFTGLYSLKVLMLQNNQLRHV 2023222928 31 Aug 2023 PTEALQNLRSLQSLRLDANHISYVPPSCFSGLHSLRHLWLDDNALTEIPVQAFR SLSALQAMTLALNKIHHIPDYAFGNLSSLWLHLHNNRIHSLGKKCFDGLHSLE TLDLNYNNLDEFPTAIRTLSNLKELGFHSNNIRSIPEKAFVGNPSLITIHFYDNPI QFVGRSAFQHLPELRTLTLNGASQITEFPDLTGTANLESLTLTGAQISSLPQTVC 5 NQLPNLQVLDLSYNLLEDLPSFSVCQKLQKIDLRHNEIYEIKVDTFQQLLSLRSL NLAWNKIAIIHPNAFSTLPSLIKLDLSSNLLSSFPITGLHGLTHLKLTGNHALQSL ISSENFPELKVIEMPYAYQCCAFGVCENAYKISNQWNKGDNSSMDDLHKKDAG MFQAQDERDLEDFLLDFEEDLKALHSVQCSPSPGPFKPCEHLLDGWLIR: hLGR5 (ECD) 10 VALYVGIAVGWAALIIIGIIIYCCCCRGKDDNTEDKEDARPNREAYEEPPEQLRE LSREREEEDDYRQEEQRSTGRESPDHLDQ: GPA33 sequence containing the TM region DYKDDDDK: FLAG 15 Mouse LGR5 The cDNA encoding full length (FL) mouse (m)LGR5 was present in pEFl_Myc / His (Invitrogen), containing a cMyc and a HIS tag (pEFl_mLgr5-Myc-HIS). The mLgr5 cDNA sequence was verified by sequencing and comparison with the NCBI Reference 20 sequence NM_010195.2. Amino acid sequence full length mouse (m)Lgr5-Myc-HIS insert in pEFl_Myc / His for expression on cell surface MDTSCVHMLLSLLALLQLVAAGSSPGPDAIPRGCPSHCHCELDGRMLLRVDCSDLGLSELPSNLSV 25 FTSYLDLSMNNISQLPASLLHRLCFLEELRLAGNALTHIPKGAFTGLHSLKVLMLQNNQLRQVPEE ALQNLRSLQSLRLDANHISYVPPSCFSGLHSLRHLWLDDNALTDVPVQAFRSLSALQAMTLALNKI HHIADYAFGNLSSLVVLHLHNNRIHSLGKKCFDGLHSLETLDLNYNNLDEFPTAIKTLSNLKELGF HSNNIRSIPERAFVGNPSLITIHFYDNPIQFVGVSAFQHLPELRTLTLNGASHITEFPHLTGTATLES LTLTGAKISSLPQAVCDQLPNLQVLDLSYNLLEDLPSLSGCQKLQKIDLRHNEIYEIKGSTFQQLFN 30 LRSLNLAWNKIAIIHPNAFSTLPSLIKLDLSSNLLSSFPVTGLHGLTHLKLTGNRALQSLIPSANFPE LKIIEMPSAYQCCAFGGCENVYKISNQWNKDDGNSVDDLHKKDAGLFQVQDERDLEDFLLDFEE DLKALHSVQCSPSPGPFKPCEHLFGSWLIRIGVWTTAVLALSCNALVALTVFRTPLYISSIKLLIGVI AWDILMGVSSAVLAAVDAFTFGRFAQHGAWWEDGIGCQIVGFLSIFASESSIFLLTLAALERGFSV KCSSKFEVKAPLFSLRAIVLLCVLLALTIATIPLLGGSKYNASPLCLPLPFGEPSTTGYMVALVLLNS 2023222928 31 Aug 2023 LCFLIMTIAYTKLYCSLEKGELENLWDCSMVKHIALLLFANCILYCPVAFLSFSSLLNLTFISPDVIK FILLVIVPLPSCLNPLLYIVFNPHFKEDMGSLGKHTRFWMRSKHASLLSINSDDVEKRSCESTQALV SFTHASIAYDLPSTSGASPAYPMTESCHLSSVAFVPCLAAARGHPFEQKLISEEDLNMHTGHHHHH H 5 Of which: MDTSCVHMLLSLLALLQLVAA signal peptide 10 GSSPGPDAIPRGCPSHCHCELDGRMLLRVDCSDLGLSELPSNLSVFTSYLDLSMNNISQLPASLLH RLCFLEELRLAGNALTHIPKGAFTGLHSLKVLMLQNNQLRQVPEEALQNLRSLQSLRLDANHISYV PPSCFSGLHSLRHLWLDDNALTDVPVQAFRSLSALQAMTLALNKIHHIADYAFGNLSSLWLHLHN NRIHSLGKKCFDGLHSLETLDLNYNNLDEFPTAIKTLSNLKELGFHSNNIRSIPERAFVGNPSLITI HFYDNPIQFVGVSAFQHLPELRTLTLNGASHITEFPHLTGTATLESLTLTGAKISSLPQAVCDQLPN 15 LQVLDLSYNLLEDLPSLSGCQKLQKIDLRHNEIYEIKGSTFQQLFNLRSLNLAWNKIAIIHPNAFST LPSLIKLDLSSNLLSSFPVTGLHGLTHLKLTGNRALQSLIPSANFPELKIIEMPSAYQCCAFGGCENV YKISNQWNKDDGNSVDDLHKKDAGLFQVQDERDLEDFLLDFEEDLKALHSVQCSPSPGPFKPCE HLFGSWLIRIGVWTTAVLALSCNALVALTVFRTPLYISSIKLLIGVIAVVDILMGVSSAVLAAVDAFTF GRFAQHGAWWEDGIGCQIVGFLSIFASESSIFLLTLAALERGFSVKCSSKFEVKAPLFSLRAIVLLCV 20 LLALTIATIPLLGGSKYNASPLCLPLPFGEPSTTGYMVALVLLNSLCFLIMTIAYTKLYCSLEKGELE NLWDCSMVKHIALLLFANCILYCPVAFLSFSSLLNLTFISPDVIKFILLVIVPLPSCLNPLLYIVFNPH FKEDMGSLGKHTRFWMRSKHASLLSINSDDVEKRSCESTQALVSFTHASIAYDLPSTSGASPAYPM TESCHLSSVAFVPCL: mLGR5 (FL) AAARGHPF: linker 25 EQKLISEEDL: cMyc-derived epitope tag NMHTG: linker HHHHHH: Hexa His tag Cloning of the cDNA encoding human ZNRF3 30 cDNA encoding human (h)ZNRF3 (Genbank NM_001206998.1) was used as template to amplify specific parts of the cDNA (the extra-cellular domain (ECD): amino acids 1 - 219, or the ECD-TM part (truncation mutant): amino acids 1 - 256). To be able to express the target protein on the surface of antigen-negative cells and to be able to generate stable cell clones, the cDNA encoding the ECD of hZNRF3 was 2023222928 31 Aug 2023 cloned into pDisplay (pDisplay_hZNRF3(ECD)-cMyc-PDGFR(TM)) and a truncation mutant (ECD with the autologous TM region) was cloned in pcDNA3.1 (pcDNA3.1_hZNRF3(ECD-TM)). The pDisplay construct allows confirmation of protein surface expression via an extra-cellular cMyc-derived epitope tag. Specific 5 primers were designed, synthesized and used to amplify the specific parts of hZNRF3. These were then cloned in pDisplay (only the ECD), resulting in pDisplay_hZNRF3(ECD)-cMyc-PDGFR(TM) and in pcDNA3.1 (ECD with TM region), resulting in pcDNA3.1_hZNRF3(ECD-TM) for expression in (antigennegative) cells. 10 Cloning of the cDNA encoding mouse ZNRF3 ECD and human RNF43 ECD and production of recombinant protein The cDNAs encoding the ECD of mouse (m)ZNRF3 (Genbank NM_001080924.2, amino acid 53-205, the signal peptide used was derived from cystatin) and the ECD 15   of human RNF43 (GenBank NM_017763, amino acid 24-109, containing the cystatin leader sequence) were used to generate recombinant purified, his-tagged proteins consisting of the ECDs of the targets, in vector pUPE (U-Protein Express BV). In brief: the constructs (Peng et al. 2013 Pios ONE 8:2-10) were transfected in Hek293E cells (293 cl8 ATCC, CRL-10852) and after a week of production, the protein-20 containing supernatant was harvested. The hexa HIS-tagged proteins were purified by means of IMAC (immobilized metal-ion affinity chromatography) and gelfiltration. Another cDNA encoding the (codon-optimized) ECD of mouse ZNRF3 was made synthetically and cloned in frame with a cMyc-derived epitope tag and the transmembrane region of the Platelet-derived growth factor receptor (PDGFR) in 25 pDisplay for expression on the cell surface (pDisplay_mZnrf3-cMyc-PDGFR(TM)). Cloning of the cDNA encoding human RNF43 The cDNA encoding human (h)RNF43 (GenBank NM_017763) was used as template to amplify specific parts of the cDNA (the extra-cellular domain (ECD): amino acid 30   1-199, or the ECD-TM part (truncation mutant): amino acid 1 - 222). To be able to express the target protein on the surface of antigen-negative cells and to be able to generate stable cell clones, the cDNA encoding the ECD of hRNF43 was cloned into pDisplay (pDisplay_hRNF43(ECD)-cMyc-PDGFR(TM)) and a truncation mutant of hRNF43 (ECD with the autologous TM region) was cloned in pcDNA3.1 2023222928 31 Aug 2023 (pcDNA3.1_hRNF43(ECD-TM)). The pDisplay construct allows confirmation of protein surface expression via an extra-cellular cMyc-derived epitope tag. Specific primers were designed, synthesized and used to amplify the specific parts of hZNRF3. These were then cloned in pDisplay (only the ECD, for the purpose of 5 immunization) and in pCDNA3.1 (ECD with TM region) for expression in (antigennegative) cells and the generation of cell clones stably expressing the target. Cloning of the cDNA encoding mouse RNF43 The cDNA encoding the ECD of mouse (m)RNF43 (Genbank NM_172448.3, amino 10 acid 1-199) was ordered as a synthetic gene and was cloned in frame with a cMyc-derived epitope tag and the transmembrane region of the Platelet-derived growth factor receptor (PDGFR) in pDisplay for expression on the cell surface pDisplay_mRnf43-cMyc-PDGFR(TM). 15 Human ZNRF3(ECD) in pDisplay amino acid sequence for expression on cell surface: MRPRSGGRPGATGRRRRRLRRRPRGLRCSRLPPPPPLPLLLGLLLAAAGPGAAR AKETAFVEWLFESSPSGDYTTYTTGLTGRFSRAGATLSAEGEIVQMHPLGLCN NNDEEDLYEYGWVGWKLEQPELDPKPCLTVLGKAKRAVQRGATAVIFDVSEN 20 PEAIDQLNQGSEDPLKRPWYVKGADAIKLMNIVNKQKVARARIQHRPPRQPTE YFDMVDEQKLISEEDLNAVGQDTQEVIWPHSLPFKVWISAILALWLTIISLIIL IMLWQKKPR Of which: 25 MRPRSGGRPGATGRRRRRLRRRPRGLRCSRLPPPPPLPLLLGLLLAAAGPGAAR A : signal peptide KETAFVEWLFESSPSGDYTTYTTGLTGRFSRAGATLSAEGEIVQMHPLGLCNN NDEEDLYEYGWVGWKLEQPELDPKPCLTVLGKAKRAVQRGATAVIFDVSENP EAIDQLNQGSEDPLKRPWYVKGADAIKLMNIVNKQKVARARIQHRPPRQPTEY 30 FDM: the ECD of human ZNRF3 VD: amino acids that are encoded by cloning sites 2023222928 31 Aug 2023 EQKLISEEDL: cMyc-derived epitope tag NAVGQDTQEVIWPHSLPFKVWISAILALVVLTIISLIILIMLWQKKPR: PDGFR sequence containing the TM region 5 Human ZNRF3 truncation mutant amino acid sequence for expression on cell surface. MRPRSGGRPGATGRRRRRLRRRPRGLRCSRLPPPPPLPLLLGLLLAAAGPGAAR AKETAFVEWLFESSPSGDYTTYTTGLTGRFSRAGATLSAEGEIVQMHPLGLCN 10 NNDEEDLYEYGWVGWKLEQPELDPKPCLTVLGKAKRAVQRGATAVIFDVSEN PEAIDQLNQGSEDPLKRPWYVKGADAIKLMNIVNKQKVARARIQHRPPRQPTE YFDMGIFLAFFVWSLVCLILLVKIKLKQRRSQNSMNRPAV Of which: MRPRSGGRPGATGRRRRRLRRRPRGLRCSRLPPPPPLPLLLGLLLAAAGPGAAR 15 A : signal peptide KETAFVEWLFESSPSGDYTTYTTGLTGRFSRAGATLSAEGEIVQMHPLGLCNN NDEEDLYEYGWVGWKLEQPELDPKPCLTVLGKAKRAVQRGATAVIFDVSENP EAIDQLNQGSEDPLKRPWYVKGADAIKLMNIVNKQKVARARIQHRPPRQPTEY FD: ECD of human ZNRF3 20 MGIFLAFFVWSLV : Predicted TM region CLILLVKIKLKQRRSQNSMNRPAV: Intra-cellular tail Mouse ZNRF3 ECD-His in pUPE soluble amino acid sequence for expression soluble protein: 25 GSKETAFVEWLFESSPSGDYTTHTTGLTGRFSRAGAMLSAEGEIVQMHPLGLC NNNDEEDLYEYGWVGWKLEQPELDPKPCLTVLGKAKRAVQRGATAVIFDVSE 2023222928 31 Aug 2023 NPEAIDQLNQGSEDPLKRPWYVKGADAIKLMNIVNKQKVARARIQHLAAAHH HHHH Of which: GS : amino acids encoded by cloning sites 5 KETAFVEVVLFESSPSGDYTTHTTGLTGRFSRAGAMLSAEGEIVQMHPLGLCN NNDEEDLYEYGWVGWKLEQPELDPKPCLTVLGKAKRAVQRGATAVIFDVSEN PEAIDQLNQGSEDPLKRPWYVKGADAIKLMNIVNKQKVARARIQHL: ECD of mouse ZNRF3 AAA : amino acids encoded by cloning sites 10 HHHHHH : Hexa His tag Mouse (m)ZNRF3 sequence in pDisplay amino acid sequence expressed on cell surface: MRPRSGGRPGAPGRRRRRLRRGPRGRRLPPPPPLPLLLGLLLAAAGPGAARAKE 15 TAFVEWLFESSPSGDYTTHTTGLTGRFSRAGAMLSAEGEIVQMHPLGLCNNN DEEDLYEYGWVGWKLEQPELDPKPCLTVLGKAKRAVQRGATAVIFDVSENPE AIDQLNQGSEDPLKRPWYVKGADAIKLMNIVNKQKVARARIQHLPPRQPTEYF DMVDEQKLISEEDLNAVGQDTQEVIWPHSLPFKVWISAILALWLTIISLIILIM LWQKKPR 20 Of which: MRPRSGGRPGAPGRRRRRLRRGPRGRRLPPPPPLPLLLGLLLAAAGPGAARA: signal peptide KETAFVEVVLFESSPSGDYTTHTTGLTGRFSRAGAMLSAEGEIVQMHPLGLCN NNDEEDLYEYGWVGWKLEQPELDPKPCLTVLGKAKRAVQRGATAVIFDVSEN 2023222928 31 Aug 2023 PEAIDQLNQGSEDPLKRPWYVKGADAIKLMNIVNKQKVARARIQHLPPRQPTE YFDM: ECD mZNRF3 VD: amino acids that are encoded by cloning sites EQKLISEEDL: cMyc-derived epitope tag 5 NAVGQDTQEVIWPHSLPFKVWISAILALVVLTIISLIILIMLWQKKPR: PDGFR sequence containing the TM region Human RNF43 in pDisplay amino acid sequence for expression on cell surface: MSGGHQLQLAALWPWLLMATLQAGFGRTGLVLAAAVESERSAEQKAIIRVIPL 10 KMDPTGKLNLTLEGVFAGVAEITPAEGKLMQSHPLYLCNASDDDNLEPGFISIV KLESPRRAPRPCLSLASKARMAGERGASAVLFDITEDRAAAEQLQQPLGLTWPV VLIWGNDAEKLMEFVYKNQKAHVRIELKEPPAWPDYDWDEQKLISEEDLNAV GQDTQEVIVVPHSLPFKWVISAILALWLTIISLIILIMLWQKKPR 15 Of which : MSGGHQLQLAALWPWLLMATLQAGFGRTGLVLAAAVESERSA : signal peptide EQKAIIRVIPLKMDPTGKLNLTLEGVFAGVAEITPAEGKLMQSHPLYLCNASDD DNLEPGFISIVKLESPRRAPRPCLSLASKARMAGERGASAVLFDITEDRAAAEQL QQPLGLTWPWLIWGNDAEKLMEFVYKNQKAHVRIELKEPPAWPDYDV: ECD 20 of human RNF43 VD : amino acids encoded by cloning sites EQKLISEEDL : Myc-derived epitope tag NAVGQDTQEVIWPHSLPFKVWISAILALVVLTIISLIILIMLWQKKPR : PDGFR sequence containing the TM region 25 Mouse RNF43 in pDisplay amino acid sequence for expression on cell surface MSGGHQLQLAVLWPWLLMATLHAGFGHTGRVLAAAVESERSAEQKAVIRVIPL KMDPTGKLNLTLEGVFAGVAEVTPAEGKLMQSHPLYLCNASDDDNLEPGFISI VKLESPRRAPRPCLSLASKARMAGERGANAVLFDITEDRSAAEQLQQPLGLTKP 2023222928 31 Aug 2023 WLIWGSDAAKLMEFVYKNRKAYVWIELKEPPAGANYDWDEQKLISEEDLNA VGQDTQEVIVVPHSLPFKVWISAILALWLTIISLIILIMLWQKKPR Of which: 5 MSGGHQLQLAVLWPWLLMATLHAGFGHTGRVLAAAVESERSA : signal peptide EQKAVIRVIPLKMDPTGKLNLTLEGVFAGVAEVTPAEGKLMQSHPLYLCNASD DDNLEPGFISIVKLESPRRAPRPCLSLASKARMAGERGANAVLFDITEDRSAAEQ LQQPLGLTKPWLIWGSDAAKLMEFVYKNRKAYVWIELKEPPAGANYDV: ECD of mouse RNF43 10 VD: amino acids encoded by cloning site EQKLISEEDL: Myc-derived epitope tag NAVGQDTQEVIWPHSLPFKVWISAILALVVLTIISLIILIMLWQKKPR: PDGFR sequence containing TM region 15 Cloning of the cynomolgus and rat orthologues of LGR5 and EGFR The cDNA encoding cynomolgus LGR5 was amplified from cynomolgus colon- and from liver cDNA using human-specific primers (Cyno-LGR5-FOR: 5’-CCAGCAGGATCCGCCGCCACCATGGACACCTCCCGGCTCGGTG-3’ and Cyno-LGR5-REV: 5’- CCAGCAGCGGCCGCTTAGAGACATGGGACAAATGCCAC-3’). 20 DMSO was added to the reaction to possibly improve the yield and specificity of the PCR reactions. Both liver and colon cDNA allowed for the amplification of the expected 2.7kb band and the PCR product obtained from colon cDNA was then used for cloning. The obtained cDNA was cloned into pcDNA3.1 (BamHl-NoG) and sequenced. The sequence encoding a chimeric EGF receptor composed of the 25 cynomolgus extra-cellular domain (also described in WO2010 / 022736-A2) coupled to the human trans-membrane and intra-cellular part was obtained from patent US2010 / 0183615-A1 (page 79) and the encoding cDNA was codon-optimised for expression in human cells, ordered and cloned by GeneArt. This cDNA was then recloned into pcDNA3.1 using Nhe\ and NoG. The cDNA’s encoding rat EGFR and 30 rat LGR5 are available through Sino Biological (cDNA encoding rat EGFR: cat. nr. RG80100-UT; GenBank reference HM801041.1) and Origene (cDNA encoding rat LGR5: cat. Nr. RN202738; GenBank reference NM_001106784). Both cDNA’s were re-cloned into pcDNA3.1 using Kpn\ and NoG. All cDNA’s were sequenced and shown to be correct. 2023222928 31 Aug 2023 Full length wt cynomolgus LGR5 amino acid sequence MDTSRLGVLLSLPVLLQLAAGSSSPRSGALLRGCPTHCHCEPDGRMLLRVDCSD LGLSELPSNLSVFTSYLDLSMNNISQLLPNPLPSLRFLEELRLAGNALTYIPKGA 5 FTGLYSLKVLMLQNNQLRQVPTEALQNLRSLQSLRLDANHISYVPPSCFSGLHS LRHLWLDDNALTEIPVQAFRSLSALQAMTLALNKIHHIPDYAFGNLSSLWLHL HNNRIHSLGKKCFDGLHSLETLDLNYNNLDEFPTAIRTLSNLKELGFHSNNIRS IPEKAFVGNPSLITIHFYDNPIQFVGRSAFQHLPELRTLTLNGASQITEFPDLTGT ANLESLTLTGAQISSLPQTVCNQLPNLQVLDLSYNLLEDLPSFSVCQKLQKIDLR 10 HNEIYEIKVDTFQQLLSLRSLNLAWNKIAIIHPNAFSTLPSLIKLDLSSNLLSSFP VTGLHGLTHLKLTGNHALQSLISSENFPELKIIEMPYAYQCCAFGVCENAYKIS NQWNKGDNSSMDDLHKKDAGMFQVQDERDLEDFLLDFEEDLKALHSVQCSP SPGPFKPCEHLLDGWLIRIGVWTIAVLALTCNALVTSTVFRSPLYISPIKLLIGVIA WNMLTGVSSAVLAGVDAFTFGSFARHGAWWENGVGCQVIGFLSIFASESSVFL 15 LTLAALERGFSVKCSAKFETKAPFSSLKVIILLCALLALTMAAVPLLGGSEYGAS PLCLPLPFGEPSTTGYMVALILLNSLCFLMMTIAYTKLYCNLDKGDLENIWDCS MVKHIALLLFTNCILYCPVAFLSFSSLLNLTFISPEVIKFILLVIVPLPACLNPLLYI LFNPHFKEDLVSLGKQTYFWTRSKHPSLMSINSDDVEKQSCDSTQALVTFTSSS IAYDLPPSSVPSPAYPVTESCHLSSVAFVPCL 20 Of which MDTSRLGVLLSLPVLLQLAAG Signal peptide SSSPRSGALLRGCPTHCHCEPDGRMLLRVDCSDLGLSELPSNLSVFTSYLDLSM 25 NNISQLLPNPLPSLRFLEELRLAGNALTYIPKGAFTGLYSLKVLMLQNNQLRQV PTEALQNLRSLQSLRLDANHISYVPPSCFSGLHSLRHLWLDDNALTEIPVQAFR SLSALQAMTLALNKIHHIPDYAFGNLSSLWLHLHNNRIHSLGKKCFDGLHSLE TLDLNYNNLDEFPTAIRTLSNLKELGFHSNNIRSIPEKAFVGNPSLITIHFYDNPI QFVGRSAFQHLPELRTLTLNGASQITEFPDLTGTANLESLTLTGAQISSLPQTVC 30 NQLPNLQVLDLSYNLLEDLPSFSVCQKLQKIDLRHNEIYEIKVDTFQQLLSLRSL NLAWNKIAIIHPNAFSTLPSLIKLDLSSNLLSSFPVTGLHGLTHLKLTGNHALQS LISSENFPELKIIEMPYAYQCCAFGVCENAYKISNQWNKGDNSSMDDLHKKDA GMFQVQDERDLEDFLLDFEEDLKALHSVQCSPSPGPFKPCEHLLDGWLIRIGV WTIAVLALTCNALVTSTVFRSPLYISPIKLLIGVIAVVNMLTGVSSAVLAGVDAFT 35 FGSFARHGAWWENGVGCQVIGFLSIFASESSVFLLTLAALERGFSVKCSAKFET KAPFSSLKVIILLCALLALTMAAVPLLGGSEYGASPLCLPLPFGEPSTTGYMVALI LLNSLCFLMMTIAYTKLYCNLDKGDLENIWDCSMVKHIALLLFTNCILYCPVAF LSFSSLLNLTFISPEVIKFILLVIVPLPACLNPLLYILFNPHFKEDLVSLGKQTYFW TRSKHPSLMSINSDDVEKQSCDSTQALVTFTSSSIAYDLPPSSVPSPAYPVTESC 40 HLSSVAFVPCL Cynomolgus LGR5 2023222928 31 Aug 2023 Generation of LGR4, LGR5, ZNRF3 and RNF43 over-expressing cell lines Constructs expressing hLGR4 (pEFl_hLGR4-FLAG-HA), hLGR5 (pEFl_hLGR5-FLAG-HA), hZRNF3(ECD) (pcDNA3.1_hZNRF3(ECD) and pDisplay_hZNRF3(ECD)-Myc-PDGFR(TM)) and hRNF43(ECD) 5 (pDisplay_hRNF43-(ECD)-Myc-PDGFR(TM)) were used to generate Freestyle 293F and CHO-K1 clones stably expressing the respective proteins. Constructs were transiently transfected in Freestyle 293F and CHO-K1 cells using PEI (Freestyle 293F cells) or lipofectamine (CHO cells) transfection and screened by FACS using antibodies reacting with the respective targets. After successful transfection both 10 Freestyle 293F and CHO-K1 cells were seeded in limiting dilution and cultured under 0.5 mg / ml G418 selection pressure to obtain stable cell clones. After 2-3 weeks of selection, clones were screened by FACS. The selected clones were expanded by serial passage, retested in FACS and frozen to -150°C. 15 Mice used for immunization For generation of human antibodies binding to LGR4, LGR5, ZNRF3 and RNF43 mice transgenic for the human VK1-39 light chain (common light chain mice, see W02009 / 157771) and for a human heavy chain (HC) minilocus (comprising a selection of human V gene segments, all human Ds and all human Js) were 20 immunized with either DNA encoding the proteins or recombinant DNA as briefly described below. These mice are referred to as ‘MeMo®’ mice. Im m un iza t io ns hLGR4 / hLGR5 DNA immunizations 25   18 mice were immunized with 20 pg plasmid DNA (pVaxl_hLGR4-FLAG-HA and pVaxl_hLGR5-FLAG-HA) expressing full length hLGR4 and hLGR5 each. Additionally 12 mice were immunized with 20 pg plasmid DNA of the extracellular domain of hLGR4 and hLGR5 fused to the transmembrane domain of GPA33 and a Flag tag (pVaxl_hLGR4(ECD)-GPA33-FLAG and pVaxl_hLGR5(ECD)-GPA33- 30 FLAG). Mice were vaccinated at day 0, 3, 6, 14, 17, 28, 31, 49, 63, 70, 84 and 91. 2023222928 31 Aug 2023 LGR4, LGR5, ZNRF3, RNF43protein immunizations Six mice were immunized with 40 pg recombinant human (rh)LGR4-Fc (RND systems Cat. Nr. 7750-GP), rhLGR5-Fc (RND systems Cat. Nr. 8078-GP), rhZNRF3-Fc (RND systems Cat. Nr. 7994-RF) or rhRNF43-Fc (RND systems Cat. nr. 79645 RN) protein dissolved in PBS, and supplemented with 40 pl Gerbu adjuvant MM (Gerbu Biotechnik). Subsequently mice were boosted with 20 pg recombinant protein (+ 20 pl Gerbu adjuvant MM) on day 14 and day 28 followed by further boosts of 20 pg recombinant protein until a serum titer was observed or the immunization period was greater than three months. 10 Determination of antibody titers Anti-hLGR4, hLGR5, hZNRF3 or hRNF43 titers in the serum from immunized mice were determined by FACS on Freestyle 293F cells over-expressing the respective target. 15 Recovery of lymphoid tissue Spleen and draining lymph nodes were removed from all mice that were successfully immunized (see table 1). Single cell suspensions were generated from both spleen and inguinal lymph nodes and subsequently these tissues were lysed in Trizol 20 reagent and stored at -80°C until use. Generation of ‘immune’phage antibody repertoires by RT-PCR cloning of VHgenes From successfully immunized mice, the inguinal lymph nodes were used for the construction of ‘immune’ phage antibody repertoires. RNA was extracted from the 25 lymphoid tissue using Trizol and lpg of total RNA was used in a RT reaction using an IgG-CHl specific primer. The resulting cDNA was then used to amplify the polyclonal pool of VH-encoding cDNA using in-house developed VH-specific primers essentially as described in Marks et al. (J Mol Biol. 1991 Dec 5;222(3):581-97). The resulting PCR product was then cloned in a phagemid vector for the display of Fab 30 fragments on phage, as described in de Haard et al. (J Biol Chem. 1999 Jun 25;274(26):18218-30) with the exception that the light chain was the same for every antibody and was encoded by the vector. After ligation, the phagemids were used to transform E.coli TGI bacteria and transformed bacteria were plated onto LB-agar 2023222928 31 Aug 2023 plates containing ampicillin and glucose. All phage libraries contained >106 transformants and had an insert frequency of > 80%. Bacteria were harvested after overnight growth and used to prepare phage according to established protocols (de Haard et al., J Biol Chem. 1999 Jun 25;274(26): 18218-30). 5 Selection of phage carrying Fab fragments specifically binding to LGR4, LGR5, ZNRF3 and RNF43 from synthetic or ‘immune’phage antibody repertoires Phage libraries were rescued according to standardized procedures (J Mol Biol. 1991 Dec 5;222(3):581-97; J Biol Chem. 1999 Jun 25;274(26):18218-30) and phage were 10 selected for two rounds of selection in case of in-house generated synthetic repertoires and a single round in case of the immune phage antibody repertoires. In the first round, recombinant protein was coated onto the wells of a MAXISORP™ ELISA plate or to a NUNC immuno-tube, whereas in the second round, either recombinant protein or cells over-expressing the target were used. The 15 MAXISORP™ ELISA plates or immuno-tubes were blocked with 4% ELK. Phage antibody libraries were also blocked with 4% ELK and excess of human IgG to deplete for Fc region binders prior to the addition of the phage library to the coated antigen. Incubation with the phage library with the coated protein was performed for 2hrs at 20 room temperature under shaking conditions. Plates or tubes were then washed five to ten times with 0.05% Tween-20 in PBS followed by 5 to 10 times washing with PBS. Bound phage were eluted using 50mM glycine (pH 2.2) and added to E. coli TG-1 and incubated at 37°C for phage infection. Subsequently infected bacteria were plated on agar plates containing Ampicillin, and glucose and incubated at 37°C 25 overnight. After the first round of selection, colonies were scraped off the plates and combined and thereafter rescued and amplified to prepare an enriched first round phage pool for the synthetic repertoires. For the ‘immune’ repertoires, single clones were screened for target binding after the first round of phage selection. For the synthetic repertoires, the enriched library was then selected on either the 30 recombinant human (rh) protein (rhLGR4-Fc, rmLgr4-Fc, rhLGR5-Fc, rhZNRF3-Fc or rhRNF43-Fc, RND systems, soluble rhRNF-43-HIS, rmZnrf3-HIS (produced inhouse)) using the protocol described above or on Freestyle 293F cells stably overexpressing hLGR4(FL), hLGR5(FL), hZNRF3(ECD) or hRNF43(ECD). For the cell selections, rescued phage and cells were blocked with 4% ELK. After blocking the 2023222928 31 Aug 2023 rescued phage were incubated with 5A106 parental Freestyle 293F cells for subtraction for Ihr. After subtraction, cells were spun down and the phage supernatant was transferred to Freestyle 293F cells expressing hLGR4, hLGR5, hZNRF3 or hRNF43. Cells plus phage were incubated for 2 hrs at 2-8°C. Washing 5 the cells (5-10 times) was performed using 5ml of 0.5% BSA in PBS. Bound phage were eluted using 200mM TEA, the eluate was neutralized with Tris (pH8) and added to E. coll TG-1 and incubated at 37°C for phage infection. Subsequently, phage-infected bacteria were plated on agar plates containing ampicillin, and glucose and incubated at 30°C or 37°C overnight. 10 After the second round selection, individual clones were picked and tested for targetreactivity. Positive phage clones binding hLGR4, hLGR5, hZNRF3, or hRNF43 were then identified in FACS for binding to the Freestyle 293F stable over-expressing the respective target (see below). 15 DiD labeling of cells and FACS staining of a mix of DiD-positive and -negative cells Freestyle 293F cell clones stably over-expressing the respective targets were generated in house. These cells were cultured and harvested using standardized procedures. Approximately 20 million antigen-expressing cells were then labeled with lgl of DiD (Invitrogen, cat. nr. V22889) in a volume of 1ml of cell culture 20 medium, for 20 minutes at 37°C. DiD labeling was checked on a small aliquot of cells in FACS and consistently found to be more than 90%. Cells were then washed twice with 20ml of cell culture medium and used subsequently for FACS staining. To this aim, a 1:1 mix of antigen-negative (parental) Freestyle 293F cells and DiD-labeled antigen-positive cells was made and aliquoted at 200,000 cells per well into round 25 bottom 96 wells FACS microtiter plates. Staining using monoclonal phage was performed as described below. FACS staining of a mix of target-positive and -negative cells using monoclonal phage Monoclonal phage of single clones selected for binding the respective targets were 30 prepared as described (J Mol Biol. 1991 Dec 5;222(3):581-97; J Biol Chem. 1999 Jun 25;274(26): 18218-30). These were tested for binding in FACS to a mix of (DiD-labeled) antigen-positive and (non-labeled)—negative cell lines by incubation with phage (30pl) in a total of lOOpl FACS buffer (PBS, containing 0.5% BSA and 0.5mM EDTA) containing 4% milk. After three washes, bound phage were detected by 2023222928 31 Aug 2023 staining with a biotinylated anti-M13 antibody (Fitzgerald, cat. nr. 61R-M101ABTB62-FEZ, 1:125 in FACS buffer, 30 minutes on ice) and PE-labeled streptavidin (Invitrogen, cat. nr. SA1004-4; 1:400 in FACS buffer for 15 minutes on ice). Stained cells were analysed using a FACS Canto (Becton and Dickinson). 5 RTK-targeting antibodies EGFR- and HER3-targeting cLC antibodies were obtained using previously described methods (J Mol Biol. 1991 Dec 5;222(3):581-97; J Biol Chem. 1999 Jun 25;274(26): 18218-30) from in-house generated large synthetic phage antibody 10 repertoires (HER3), or from phage antibody repertoires generated from successfully target-immunised MeMo mice (EGFR). Methods to generate antibodies to EGFR and HER3 and antibody variable domain VH chains for the respective EGFR and HER3 antibodies have been described in pending applications that are incorporated herein by reference: WO 2015 / 130173 Al and WO 2015 / 130172 Al. 15 Re-cloning of VH-encoding cDNA’s from the phagemid vector to IgG-expression vectors The VH-encoding cDNA’s of all target-specific clones were sequenced. A selection of unique clones based on sequence identity and cluster analysis (Figure 25) was then 20 re-cloned to different IgG expression vectors using Sfil-BstEII or a SfiUXhol digestion and ligation of the pool of digested cDNA’s into the IgG expression plasmid according to standardised molecular biological techniques. Generation of bispecific antibodies 25 Bispecific antibodies were generated by transient co-transfection of two plasmids encoding IgG with different VH domains, using a proprietary CH3 engineering technology to ensure efficient hetero-dimerisation and formation of bispecific antibodies. The common light chain is also co-transfected in the same cell, either on the same plasmid or on another plasmid. In our co-pending applications (e.g. 30   WO2013 / 157954 and WO2013 / 157953; incorporated herein by reference) we have disclosed methods and means for producing bispecific antibodies from a single cell, whereby means are provided that favor the formation of bispecific antibodies over the formation of monospecific antibodies. These methods can also be favorably employed in the present invention. Specifically, preferred mutations to produce 2023222928 31 Aug 2023 essentially only bispecific full length IgG molecules are amino acid substitutions substitutions at positions 351 and 366, e.g. L351K and T366K (numbering according to EU numbering) in the first CH3 domain (the 'KK-variant' heavy chain) and amino acid substitutions at positions 351 and 368, e.g. L351D and L368E in the second CH3 5 domain (the 'DE-variant' heavy chain), or vice versa. It was previously demonstrated in our co-pending applications that the negatively charged DE-variant heavy chain and positively charged KK- variant heavy chain preferentially pair to form heterodimers (so-called 'DEKK' bispecific molecules). Homodimerization of DEvariant heavy chains (DE-DE homodimers) or KK-variant heavy chains (KK-KK 10 homodimers) hardly occurs due to strong repulsion between the charged residues in the CH3-CH3 interface between identical heavy chains. VH genes encoding the antibodies binding LGR4, LGR5, ZNRF3 and RNF43 described above were cloned into the vector encoding the positively charged CH3 15 domain and RTK (EGFR- or HER3-) targeting antibodies as previously obtained and disclosed in WO 2015 / 130172 (incorporated herein by reference) were cloned into vector encoding the negatively charged CH3 domain. Suspension growth-adapted 293F Freestyle cells were cultivated in T125 flasks on a shaker plateau until a density of 3.0 x 106 cells / ml. Cells were seeded at a density of 0.3-0.5 x 106 viable 20 cells / ml in each well of a 24-deep well plate. The cells were transiently transfected with a mix of two plasmids encoding different antibodies, cloned into the proprietary vector system. Seven days after transfection, the cellular supernatant was harvested and filtered through a 0.22 pM filter (Sartorius). The sterile supernatant was stored at 4°C until purification of the antibodies. 25 Generation of monoclonal antibodies A selection of VH sequences were also re-cloned into an IgGl expression vector encoding mono-specific, bivalent IgG. Suspension adapted 293F Freestyle cells were cultivated in T125 flasks at a shaker plateau until a density of 3.0 x 106 cells / ml. 30 Cells were seeded at a density of 0.3-0.5 x 106 viable cells / ml in each well of a 24-deep well plate. The cells were transiently transfected with individual sterile DNA: PEI mixtures according to standardized procedures and further cultivated. Seven days after transfection, supernatant was harvested and filtered through a 0.22 pM 2023222928 31 Aug 2023 (Sartorius) filter. The sterile supernatant was stored at 4°C until antibody was purified by means of protein-A affinity chromatography. Cloning and expression of comparator antibodies targeting LGR5, FZD7 and R-5 spondinS. Antibodies that specifically recognise EGFR, FZD, RSPO3 or LGR5 are known in the art. Comparator antibodies were constructed according to published information: cDNA sequences encoding the VH- and VL were derived from published patents and cloned into an expression vector encoding a full length human IgGl molecule. 10 Antibodies were subsequently expressed in 293F Freestyle cells by transient transfection and purified from the culture supernatant using protein-A affinity chromatography according to standard procedures. The hu8Ellv2 (anti-LGR5) antibody was copied from patent US 2013 / 0336885 Al (Genentech). Sequence information for the BNC101 antibody (anti-LGR5) was obtained from patent 15   US2016 / 0031984 Al (Bionomics Inc.). The sequence encoding the OMP18R5 antibody (anti-FZD) was copied from patent AU2014 / 212081 Al (Oncomed Pharmaceuticals Inc.). The OMP18R20 and OMP18R21 antibody sequences (anti-LGR5) were found in and copied from patent US 8,628,774 B2 (Oncomed Pharmaceuticals Inc.). The sequence encoding OMP131R10 (anti-RSPO3) was copied 20 from patent WO 2016 / 090024 A2 (Oncomed Pharmaceuticals Inc.). A clinical batch of cetuximab (Erbitux®) was used. A list of the copied antibodies and the internal number given to these versions is given in Table 7. IgG purification for functional screening 25 Purification of IgG was performed on a small scale (< 500 pg), medium scale (<10 mg) and large scale (>10 mg) using protein-A affinity chromatography. Small scale purifications were performed under sterile conditions in 24 well filter plates using filtration. First, the pH of the medium was adjusted to pH 8.0 and subsequently, IgG-containing supernatants were incubated with protein A Sepharose CL-4B beads 30   (50% v / v) (Pierce) for 2hrs at 25°C on a shaking platform at 600 rpm. Next, the beads were harvested by filtration. Beads were washed twice with PBS pH 7.4. Bound IgG was then eluted at pH 3.0 with 0.1 M citrate buffer and the eluate was immediately neutralized using Tris pH 8.0. Buffer exchange was performed by centrifugation using multiscreen Ultracel 10 multiplates (Millipore). The samples were finally 2023222928 31 Aug 2023 harvested in PBS pH7.4. The IgG concentration was measured using Octet. Protein samples were stored at 4°C. IgG quantification using Octet 5 To determine the amount of IgG purified, the concentration of antibody was determined by means of Octet analysis using protein-A biosensors (Forte-Bio, according to the supplier’s recommendations) using total human IgG (Sigma Aldrich, cat. nr. 14506) as standard. 10 Characterization of binding of LGR4 / LGR5 / ZNRF3 / RNF43 specific IgG Antibodies targeting LGR4, LGR5, ZNRF3 or RNF43 were first expressed as bispecific common light chain antibodies with a second Fab arm recognizing a nonrelevant (control) antigen: Tetanus Toxoid. The antibodies were tested for binding in FACS to Freestyle 293F cells overexpressing hLGR4, hLGR5, hZNR3 or hRNF43. 15 Therefore cells were harvested and diluted to 106cells / ml in FACS buffer (PBS / 0.5%BSA / 0.5mM EDTA). 1-2 xlO5 cells were added to each well in a U-bottom 96 well plate. Cells were centrifuged for 2 minutes at 300 g at 4°C. Supernatant was discarded by inverting the plate(s). 50pl of each IgG sample was added (for screening diluted to a concentration of 5gg / ml in FACS buffer) and incubated for 1H on ice. 20 Cells were centrifuged once, supernatant was removed and cells were washed twice with 150)11 of FACS buffer. 50pl diluted 1:400 goat anti human IgG PE (Invitrogen) was added and incubated for 30 minutes on ice in the dark. After adding FACS buffer, cells were centrifuged once, supernatant was removed and cells were washed twice with FACS buffer. Cells were analyzed on a FACSCanto Flow cytometer 25 (Becton and Dickinson) in a HTS setting. Binding of the antibodies to cells was assessed by measuring the mean fluorescence intensity (MFI) of the stained cell population. Antibodies were considered to bind their target when the MFI was at least five-fold that of the same cell population stained with a (negative control) nonbinding antibody (directed to tetanus toxoid). 30 To test for binding reactivity, ELISA assays were also used. LGR4 and LGR5 targeting bispecific IgG were tested for reactivity against the antigens rhLGR4-Fc, rhLGR5-Fc and Tetanus Toxoid. ZNRF3 and RNF43 antibodies were tested for reactivity against the antigens rhZNRF3-Fc, rhRNF43-Fc and Tetanus Toxoid. 2023222928 31 Aug 2023 Antigens were coated overnight to MAXISORP™ ELISA plates. Wells of the ELISA plates were blocked with PBS (pH 7.2) containing 5% BSA for 1 hour. Selected antibodies were tested at a concentration of 5gg / ml diluted in PBS-5% BSA and allowed to bind for 1 hour at 25°C. Alternatively when titrating the bispecific IgG, a 5 seven step two-fold dilution series was prepared starting at 5pg / ml or 8pg / ml. As a control, the procedure was performed simultaneously with a commercially-available antibody specific for the coated antigens and an anti-Tetanus Toxoid control antibody. The ELISA plates were washed 3 times with PBS-T (PBS-0.05% v / v Tween 20). Bound IgG was detected with 1:2000 diluted HRP-conjugate (Goat anti-human 10 IgG Becton Dickinson) and was allowed to bind for 1 hour at 25°C. The ELISA plates were washed 3 times with PBS-T (PBS-0.05% Tween 20) and bound IgG was visualized by TMB / H2O2 staining and staining was quantified by means of OD450nm measurement. 15  Affinity ranking of LGR4 / LGR5 / ZNRF3 / RNF43 specific IgG in FACS Cells were harvested and diluted to 106cells / ml in FACS buffer (PBS / 0.5%BSA / 0.5mM EDTA). 1-2 xlO5 cells were added to each well in a U-bottom 96 well FACS plate. Cells were centrifuged for 2 minutes at 300g at 4°C. Supernatant was discarded by inverting plate(s). 50pl of each IgG sample was added in a seven step 20 two-fold serial dilution starting at 5gg / ml and incubated for lhr on ice. Cells were centrifuged once, supernatant was removed and cells were washed twice with 150pl of FACS buffer. 50pl 1:400 diluted mouse anti human IgG PE (Invitrogen) was added and incubated for 30 minutes on ice in the dark. After adding FACS buffer, cells were centrifuged once, supernatant was removed and cells were washed twice with FACS 25 buffer. Cells were analyzed on a FACSCanto Flow cytometer in a HTS setting. Binding of the antibodies to cells was quantified by measuring the mean fluorescence intensity (MFI) and calculating the area under the curve (AUC) resulting from the resulting plots of the MFI as a function of the antibody concentration used for staining. 30 IgG purification for functional studies Medium scale purifications were performed on an AKTAexplorer 100 system using HiTrap MabSelect Sure columns and HiTrap desalting columns. Samples were loaded at 5 mVmin. The column was washed with 2 column volumes of PBS. IgG was 2023222928 31 Aug 2023 eluted at pH 3.0 with 0.1 M citrate buffer. Next the sample was desalted and ended up in a final buffer of PBS pH 7.4. IgG were filtered through a 0.45 pM filter (Sartorius). The IgG concentration was measured using OD280. Protein samples were stored at -80°C. 5 Testing antibodies for their reactivity with the mouse orthologue of the target To test for mLgr4 binding reactivity, an ELISA assay was used. Both LGR4- and LGR5-targeting antibodies were tested for reactivity against the recombinant mLgr4-Fc (RND systems, Cat. nr. 8077-GP) protein. mLgr4-Fc was coated overnight 10 to MAXISORP™ ELISA plates. Wells of the ELISA plates were blocked with PBS (pH 7.2) containing 5% BSA for 1 hour. Selected antibodies were tested at a single concentration of 5gg / ml diluted in PBS-5% BSA and allowed to bind for 1 hour at 25°C. As a control, the procedure was performed simultaneously with a commercially-available antibody specific for the coated antigens and a control (anti-15 TT cLC) antibody. The ELISA plates were washed 3 times with PBS-T (PBS-0.05% v / v Tween 20). Bound IgG was detected with 1:2000 diluted HRP-conjugate (Goat anti-human IgG; Becton Dickinson) and was allowed to bind for 1 hour at 25°C. The ELISA plates were washed 3 times with PBS-T (PBS-0.05% Tween 20) and bound IgG was visualized by TMB / H2O2 staining; staining was quantified by means of 20 OD450nm measurement. Bispecific IgG were also tested for binding in FACS to Freestyle 293F cells transiently expressing mLgr5, mZnr3 or mRnf43. Therefore cells were transiently transfected with mLgr5, mZnrf3 or mRnf43-encoding constructs (pEFl_mLgr5-25 Myc-HIS, pDisplay_mZnrf3-Myc-PDGFR(TM), pDisplay_mRnf43-Myc- PDGFR(TM)) using lipofectamine and were harvested and diluted to 106cells / ml in FACS buffer (PBS / 0.5%BSA / 0.5mM EDTA). 1-2 xlO5 cells were added to each well in a U-bottom 96 well plate. Cells were centrifuged for 2 minutes at 300 g at 4°C. Supernatant was discarded by inverting plate(s). 50pl of each IgG sample was 30 added at a concentration of 5gg / ml and incubated for 1 hour on ice. Cells were centrifuged once, supernatant was removed and cells were washed twice with FACS buffer. 50gl diluted 1:400 mouse anti human IgG PE (Invitrogen) was added and incubated for 30-60 minutes on ice in the dark. After adding FACS buffer, cells were centrifuged once, supernatant was removed and cells were washed twice with 2023222928 31 Aug 2023 FACS buffer. Cells were analyzed on a FACSCanto Flow cytometer in a HTS setting. Binding of the antibodies to cells was quantified by measuring the mean fluorescence intensity (MFI) of the transfected cell population. 5 R-SpondinS blocking ELISA assay All four WNT targets have R-Spondin as their ligand (Prog Biophys Mol Biol. 2015 Sep;118(3):112-8; J Struct Biol. 2015 Aug;191(2):149-55). For each target, a ligandblocking assay was developed to test the ability of target (LGR4, LGR5, ZNRF3 or RNF43) specific antibodies to interfere with R-Spondin3 binding to the target. 10 Binding of the Fc fusion proteins of the ECD of the respective target to coated R-Spondin3 was tested in the presence of an excess of cLC IgG directed to LGR4, LGR5, ZNRF3 or RNF43. In case the cLC IgG binds to the R-Spondin3 binding site, the Fc fusion protein would no longer be able to bind to the coating and the ELISA signal would be lost. Recombinant R-Spondin3 (RND systems) was coated onto the wells of 15 a MAXISORP™ ELISA plate. Wells of the ELISA plates were blocked with PBS (pH 7.2) containing 5% BSA for 1 hour. Selected antibodies were tested for blocking at a concentration of 15gg / ml diluted in PBS-5% BSA in the presence of recombinant human target protein (rhLGR4-Fc, rhLGR5-Fc, rhZNRF3-Fc or rhRNF43-Fc). The IgG / recombinant human target protein complex was pre-incubated for 10 minutes 20 before addition to the R-Spondin3 coated plate for 10 minutes - 2 hours. As a control for blocking, the procedure was performed simultaneously by addition of a surplus (15pg / ml) of rhR-Spondin3 instead of IgG. The ELISA plates were washed 3 times with PBS-T (PBS-0.05% v / v Tween 20). Bound Fc-protein was detected with 1:2000 diluted anti-human IgG HRP-conjugate (Goat anti-human IgG Bethyl labs) and was 25 allowed to bind for 1 hour at 25°C. The ELISA plates were washed 3 times with PBS-T (PBS-0.05% Tween 20) and bound complex was detected by staining with TMB / H2O2; staining was quantified by means of OD450nm measurement. Affinity measurement of bispecific antibody binding to cell-surface expressed antigen. 30 Afucosylated PB10651 was radio-labelled with 125I using IODO-GEN according to the protocol described by van Uhm et al. The immuno-reactivity of the antibody after radiolabeling was investigated with the method described by Lindmo et al. Steady state cell affinity measurements of 125LPB10651 were performed with CHO cells expressing either EGFR or LRG5 to investigate the affinity towards EGFR and 2023222928 31 Aug 2023 LGR5 respectively. In addition, the affinity towards the DLD-1 cell line endogenously expressing EGFR but no detectable LGR5 was also determined. The assay used a constant concentration of target (cells) and the amount of radio ligand was titrated without violating the assumptions behind affinity measurements at 5 steady state conditions. Non-specific binding (NSB) was assessed by the presence of 100-fold molar excess unlabeled PB10651 in a parallel series. The assay was repeated twice and the estimated Kd value is reported as the mean of three independent experiments. Estimation of the Kd values were performed using GraphPad Prism v. 6.Oh non-linear regression, One-Site -- Total and Non-specific 10 binding with the constraint that Kd values must be greater than 0. References: Lindmo T, Boven E, Cuttitta F, Fedorko J, Bunn PA. Determination of the immunoreactive fraction of radiolabeled monoclonal antibodies by linear extrapolation to binding at infinite antigen excess. J Immunol Methods. 1984; 72: 15   77-89. van Uhm JI, Visser GW, van der Schans MJ, Geldof AA, Meuleman EJ, Nieuwenhuijzen JA. The ultimate radiochemical nightmare: upon radio-iodination of Botulinum neurotoxin A, the introduced iodine atom itself seems to be fatal for the bioactivity of this macromolecule. EJNMMI Res. 2015; 5: 5. 20 2023222928 31 Aug 2023 Epitope mapping through shotgun mutagenesis analysis The epitopes on EGFR and LGR5 recognised by PB10651 were determined by shotgun mutagenesis analysis according to the method described by Davidson et al., (2014). Two mutation libraries were made from the two antigens: one library 5   encompassed a.a. 300-520 (ligand binding domain L2 or domain III) of human EGFR (GenBank reference sequence NP_005219.2) and the other a.a. 22-560 (being the N-terminal domain until the first transmembrane helix) of human LGR5 (GenBank reference sequence AAH96324.1). The LGR5 expression construct was truncated at a.a. 834 to increase cell surface expression of the receptor. In-house developed 10 antibodies targeting a different epitope were used as control antibodies for the expression of the mutants. Reference Davidson, E. and Doranz, B.J. (2014) A high-throughput shotgun mutagenesis approach to mapping B-cell antibody epitope. Immunology 143, 13-20. 15 Competition for LGR5 binding between the LGR5 Fab arm in PB10651 and the ligand R-spondinl using a cell-based assay. The literature-copied version of antibody OMP88R20 (called PG7711) described in patent US 8,628,774B2) was used as a ligand-blocking control to set up an assay to 20 demonstrate ligand-blocking capacity of the anti-LGR5 Fab arms. A CHO-K1-derived cell clone was generated that over-expressed human LGR5 by transient transfection of CHO-K1 cells with the expression construct encoding LGR5, followed by selection of antibiotic (G418) resistant clones by limiting dilution. The binding of the copied version of OMP88R20 to this cell line was then tested in a dilution series 25 of antibody and the EC50 for binding was determined. Next, binding of the antibody to the LGR5 expressing CHO cell clone at the EC50 concentration was measured in FACS in the presence of increasing amounts of the ligand R-spondinl (R&D Systems, cat. nr. 4645-RF / CF). To test whether the binding of the anti-LGR5 Fab (MF5816) of PB 10651 to LGR5 could be inhibited by binding of the ligand, the antibody was 30 tested for LGR5 binding at lOOng / ml in the presence of increasing amounts of the ligand R-spondinl. A similar assay was performed using the rat anti-LGR5 antibody 1D9 that has been reported to bind to the juxta- membrane region of LGR5 (de Lau et al., 2011) to show the specificity of the interaction. 2023222928 31 Aug 2023 Ligand blocking capacity of the anti-EGFR Fab arm in PB10651. To test anti-EGFR IgG for their effects on EGF-induced signalling, they were tested for their ability to prevent the EGF-induced apoptotic cell death of A431 cells. In brief, high (lOnM) concentrations of EGF induce (apoptotic) cell death in A431 cells 5 (Gulli et al., 1996). This effect can be dose-dependently reverted by the addition of ligand-blocking anti-EGFR antibodies, such as cetuximab (the murine 225 antibody is the mouse equivalent of cetuximab). A431 cells were plated at 1500 cells / well in 96 wells tissue culture plates and grown overnight. The next day, antibody was added at the indicated concentrations together with 62.5ng / ml (lOnM) of 10 recombinant, human EGF (R&D Systems, cat. nr. 236-EG) and cells were grown for three days. After three days, the number of metabolically active cells was determined by alamar blue (Invitrogen, cat. nr. DALI 100) addition and measurement of the fluorescence at 590nm emission with 560nm excitation. All anti-EGFR IgG were tested for their EGF blocking effects in this assay compared with cetuximab. 15 Reference: Gulli, L.F., et al., Epidermal growth factor-induced apoptosis in A431 cells can be reversed by reducing the tyrosine kinase activity. Cell Growth Differ, 1996. 7(2): p. 173-178. 20 Heat stability assay In order to get an indication on the stability of the bispecific IgG, all IgG were incubated at 40°C for a week in serum containing medium (DMEM, high glucose (Gibco, cat. nr. 41966-029), supplemented with 9% Fetal bovine serum (Thermo Scientific Cat. nr. SV30180)) and were then tested for binding in a binding ELISA 25 (essentially as described above). This ELISA consisted of coating 2gg / ml antigen (rhLGR4-Fc, rhLGR5-Fc, rhZNRF3-Fc or rhRNF43-Fc), using 100gl at 5gg / ml IgG and blocking in 5% BSA in PBS. In this assay the binding of the same IgG (in serum containing medium) kept at 2-8°C (refrigerator) to antigen was compared to that of IgG kept at 40°C. The percentage loss of binding after 1 week incubation at 40°C was 30 calculated. Colorectal cancer (CRC) organoid cultures CRC organoids were produced as described (Van de Wetering et al. 2015 Cell 161:933-45) as working cell banks and shipped for screening assays on dry ice as 2023222928 31 Aug 2023 frozen vials at a density of 1,500,000 cells per 1ml freezing medium (Fetal Bovine Serum containing 10% DMSO as a cryoprotectant). The cryo-tubes are stored at -80°C for use within 3 months or at -150°C for long-term storage. 5 Culture media Tumoroid Expansion Medium was produced by enriching 500ml Advanced DMEM (Thermo Fisher 12491-023) with 5ml lOOx Penicillin-Streptomycin (Thermo Fisher 15140-122), 5ml lOOx Glutamax (Thermo Fisher 35050-038) and 5ml IM Hepes (Thermo Fisher 15630-056). To 70ml of the enriched Advanced DMEM, 20ml R-10 spondin 1 conditioned medium and 10ml of Noggin-conditioned medium (Van de Wetering et al. 2015 Cell 161:933-45) was added to prepare 100ml Tumoroid Expansion Medium which was additionally supplemented with 2ml 50x B27 supplement (Thermo Fisher 17504-044), 1ml IM Nicotinamide (Sigma-Aldrich N0636), 250)11 500mM N-Acetyl Cysteine (Sigma-Aldrich A9165), 10gl 5mM A83-01 15 (TGFB inhibitor, Tocris 2939) and 33gl 30mM SB202190 (p38 inhibitor, Sigma Aldrich S7067). The Tumoroid Expansion Medium was further supplemented with lOOpl lOmM Y27632 (Rho kinase inhibitor, Abmole Y-27632 dihydrochloride) upon fresh seeding of colon tumoroids in the presence of human EGF (Peprotech AF-100-15) or human NRG-l / HRG (ImmunoTools 11343047). EGF and HRG are growth 20 factors that stimulate the organoid expansion and their dose determines the sensitivity of the screening assay. EGF was added at doses of 2.5ng / ml, 5ng / ml or lOng / ml during screening or lOng / ml or 50ng / ml during expansion. HRG was used solely at 5ng / ml. Wild type organoid Expansion Medium is equal to the Tumoroid Expansion Medium, 25 with one replacement: the 70ml enriched Advanced DMEM was replaced by a combination of 20ml enriched Advanced DMEM and 50ml WNT3A-conditioned medium (Van de Wetering et al. 2015 Cell 161:933-45). Normal tissue-derived colon organoids and colon tumoroids with wild type APC are WNT-dependent and therefore require the presence of WNT for expansion. 30 Gel composition Frozen colon tumoroids were thawed rapidly in a water bath at 37°C and collected in 5ml enriched Advanced DMEM. The organoids were pelleted by 5 minute centrifugation at lOOOrpm at 4°C. The supernatant was removed and the organoids 2023222928 31 Aug 2023 taken up in Tumoroid Expansion Medium without growth factors. This organoid suspension was mixed with Cultrex Reduced Growth Factor Basement Membrane Extract, Type 2, PathClear (Amsbio 3533-010-02). The final Cultrex gel percentage was 60% and the number of cells per ml was 100,000. 5 Determination of growth factor responsiveness of patient-derived organoids In order to determine whether patient-derived organoids were responsive to growth factor treatment, they were seeded as described above in the presence or absence of growth factors (EGF (5ng / ml), or NRG (5ng / ml)) and then cultured for 5 days. The 10 number of viable cells was then determined using the Cell Titer Gio cell viability assay (Promega, cat. nr. G7571). The luminescence readout using growth factor-stimulated cells was then compared to that obtained using non-stimulated cells. Preparation of culture plates 15 The gelation was more rapid in pre-warmed culture plates. Therefore all culture plates were placed at 37°C in a humidified CO2 incubator (Eppendorf) the day before cell seeding. To expand colon tumoroids, 24-wells or 6-wells plates (Greiner Bio-One) were used and per well, either 3 or 10 drops of 15pl geVorganoid suspension was spotted at 20 regular distances. Tumoroid Expansion Medium (0.5ml or 2ml) containing between lOng / ml to 50ng / ml EGF was added after a 30 minute gelation period at 37°C. At day 1 of seeding the Tumoroid Expansion Medium contained 10pM Y27632. Medium replacements during expansion were with EGF-containing Tumoroid Expansion Medium devoid of Y27632. 25 To perform a screen, 384-wells pclear plates (Greiner Bio-One 781091) were used. Per well, 15 pl of the geVorganoid mix was dispensed using automated liquid handling. Upon 30 minutes gelation at 37°C, 45pl Tumoroid Expansion Medium (or Organoid Expansion Medium where applicable) was added on top of the gel in each well. The media were supplemented with or without growth factors and (reference) 30 antibodies and compounds were mixed with the medium in v-bottom 96-wells plates before applying to the 384-wells plates with solidified gel. Preparation of antibody master plates 2023222928 31 Aug 2023 Reference antibodies (Cetuximab (4°C), negative control antibodies, single arm HER3 or EGFR targeting antibodies and HER3 / EGFR antibodies (on dry ice)) were shipped and stored at 4°C for screening. Bispecific and monospecific antibodies were delivered in deep-well 96-wells plates that were sealed and shipped at 4°C. In 5 general, the notation to monospecific cLC antibodies throughout the examples is recognized by the prefix ‘PG’ whereas the notation to bispecific cLC antibodies is recognized by the prefix ‘PB’. For the avoidance of doubt, the notation to Fab fragments of cLC antibodies are recognized by the prefix ‘MF’. The antibodies were manually transferred to four v-bottom 96-wells plates (Greiner Bio-One 736-0118) in 10 randomized locations ranging from well B02 to well Gil (inner 60 wells). Reference antibodies were added to the plates at random locations as well, at equal concentration. These antibody master plates were used to prepare 1:10 dilution plates in PBS. The master plates and dilution plates were stored sealed at 4°C. For validation of screening results a lead panel of bispecific IgG (46 antibodies at a 15 concentration of 0.5mg / ml) were shipped in screw-capped microvials, to allow easy randomization of the antibodies in screening plates and to prevent crosscontamination and evaporation. Prior to each experimental run, the bispecific IgG were placed in one v-bottom 96-wells plate (inner 60 wells) along with reference antibodies at O.lmg / ml by diluting them in PBS. This plate was diluted once more 20   1:5 in PBS to achieve a second master plate containing antibodies at 20gg / ml. Dilutions and plate exposures were performed using the Felix liquid handler. Exposure regimes The high dose and low dose v-bottom 96-well antibody master plates were diluted 25   1:10 in culture medium before exposure. The antibody concentrations applied in primary screen were lOpg / ml and lpg / ml or 40pg / ml and 4pg / ml; and in the validation screen the antibody doses were lOpg / ml and 2pg / ml. The antibodies were added to the organoids 30 minutes after seeding. The antibody exposure before plate fixation was minimally 7 days and maximally 9 days. 30 Fixation and imaging To prepare the exposed tumoroid plates for imaging, the organoids were fixed and stained to visualize the nuclei and the actin cytoskeleton respectively as previously described (Di et al PlosOne 2014, PMID 25289886). Imaging of the plates was 2023222928 31 Aug 2023 performed using a Molecular Devices ImageXpress Micro XLS connected to a Twister II robotic arm as previously described (Sandercock et al, Molecular Cancer 2015, PMID 26227951). Briefly, z-stacks of each well in a 384-wells plate was captured using a 4x lens, with a z-step size of 50pm. The number of sections per well ranged 5 from 20 sections to 24 sections, to cover the entire depth range of the gel in each well. Image analysis Captured images were stored on a central data server, accessible by the OcellO Ominer™ 3D image analysis platform which allows direct parallel analysis of the 10 3D image stacks by its distributed computational design. The software analyses the structure of the objects (nuclei and cytoskeleton) detected in each well, and their relative positions. Upon analysis, the output was checked to detect the quality of the raw images and the analysis method. The per object measurements the software produced (for the nuclei, the organoids, nuclei within organoids, the lumens, the 15 relative positioning of lumens within organoids and the entire structure (organoids, nuclei and lumens)) were subsequently aggregated per well and the data coupled to the plate layout information (cell line, growth factor condition, treatment, etc.). Upon data aggregation, the data were checked for consistency within control treatments, absence of edge effects, consistency between replicates and the z’-factor between 20 positive and negative controls. Next, the data were z-score normalized and inspected through loading the data into TIBCO Spotfire® to purge additional outliers. 500 different morphological features were collected; The data was then run through a series of statistics that made a sub-selection of 3 to 20 of the ~500 features gathered from the z-stack images, based on the ability of this set of features to distinguish the 25 reference treatment effect from the negative control morphology. The distance between the reference and the negative controls was calculated as a Euclidian distance measurement (Figure 5) and scaled between zero and one. This unified score of morphology change was used to discriminate hits in the compound screens. The individual selected feature measurements, together with corroboration with the 30 images was used to substantiate and verify the effects of the hit compound treatments on the organoids. Z'-factor: The Z'-factor is a statistical measure for quality of a high throughput screening assay and indicates the separation window between positive and negative 2023222928 31 Aug 2023 controls. The Z'-factor is defined as 1 minus 3 times the sum of the standard deviations of the positive and negative controls divided by the absolute difference between the means of the positive and negative controls. Z'-values smaller than 0 indicate that there is too much overlap between negative and positive controls, 5 values between 0 and 0.5 indicate a useful but marginal screening window and values between 0.5 and 1.0 indicate an excellent assay with a strong separation between positive and negative controls. FACS staining of cells obtained from organoid P18T using selected anti-LGR5 cLC 10 antibodies Organoids derived from a colorectal cancer sample were cultured in 100% Basement Membrane Extracts (BME, Amsbio), at 37°C and 5% CO2, with media composed of Advanced DMEM / F12 (Invitrogen) supplemented with: 2mM GlutaMax (Invitrogen), lOmM HEPES (Invitrogen), lx B27 retinoic acid free (Invitrogen), 15 50ng / mL EGF (Peprotech), O.lpg / mL Noggin (Peprotech), Rock-inhibiter Y-27632 (Sigma-Aldrich), lOnM PGE2 (Sigma-Aldrich), 3gm SB202190 (Sigma-Aldrich), lOnM Gastrin (Tocris), lpg / ml R-SPO1 (home-made), lOmM Nicotinomide (Sigma-Aldrich), 1.25mM N-Acetyl-cysteine (Sigma-Aldrich), 0.5gM A83-01 (Tocris). The day prior to analysis, the organoids were disaggregated into single cells. To this aim, 20 the organoids were first liberated from the BME by removing the culturing media, and re-suspending the BME in cell recovery solution (BD Biosciences), and incubating for 1 hour on ice. Subsequently, the organoids were centrifuged (all centrifuge steps were for 5 minutes, 200g at 4°C). The pellet was re-suspended in 1mL of 50% Trypsin / EDTA Solution (TE); 50% PBS, and pipetted up and down, and 25 regularly visually assessed until a single cell suspension was achieved. The TE was diluted in 10mL of PBS and centrifuged. The cells were washed twice in 10mL of PBS before re-suspending in BME and aliquoting into 50gL drops on to pre-warmed plates (37°C). The BME drops were left to set for 15 minutes before 500pL of media were added per drop. After 12 hours the cells were isolated from the BME using cell 30 recovery solution. After 1 hour on ice, the cells were centrifuged, and washed once in 10mL of PBS containing 0.5% BSA and 0.5mM EDTA (staining buffer). The pellet was then re-suspended in staining buffer and counted. A maximum of 100,000 cells / lOOpL of antibody was used. After counting the appropriate number of cells, they were centrifuged and re-suspended in lOOpL of the staining buffer containing 2023222928 31 Aug 2023 the primary antibody (monoclonal and bispecific IgG) diluted to lOpg / mL. The cells were incubated on ice for 45 minutes, with regular inversion of the tubes to ensure homogeneous staining. After the incubation the cells were washed in 1mL of staining buffer and centrifuged. The cells were washed again in 1mL of staining buffer before 5 incubating with lOOpL staining buffer containing an anti-human IgG antibody conjugated to R-PE (Invitrogen, H10104) diluted 1:400. The cells were incubated for 20 minutes on ice, protected from light. After incubating, the cells were washed twice in 1mL of staining buffer before re-suspending them in staining buffer containing O.lpM DAPI (Sigma-Aldrich). The cells were maintained on ice, protected from light, 10 and analyzed immediately. Doublets were excluded using SSC-W vs SSC-A, and DAPI was used to exclude dead cells. Gating of the LGR5 antibodies was set based upon the staining of negative control antibody which was raised against Tetanus Toxin (MF1337). Fluorescence was detected using a BD FACS Aria Fusion using the UV laser and 450 / 50 filter set for DAPI, and the green laser with the 582 / 15 filter to 15 detect the R-PE fluorescence. LGR5 mRNA enrichment after sorting To assess whether the LGR5 FACS staining enriched for cells expressing LGR5, the cells were sorted with the sorting gate set so that the highest and lowest 15% of 20 stained cells were isolated. A total of 2000 cells were sorted into picroprofiling buffer (provided by the IRB genomics facility), and the sorted cells were then processed by the IRB genomics facility for RNA extraction and cDNA synthesis. LGR5 expression was assessed using quantitative PCR using TaqMan probes and TaqMan Universal PCR Master Mix (both from Applied Biosystems). The StepOnePlus real-time PCR 25 machine (Applied Biosystems) was used to run the reactions in a clear optical 96-well reaction plates with optical covers, following the manufacturer’s instructions. Expression between the negative and positive LGR5 fractions were assessed using an LGR5 probe (Hs00173664_ml) and normalized using the expression of the endogenous control gene B2M (Hs99999907_ml). Differences in target gene 30 expression were determined using the StepOne 2.2 plus software. P18 staining for LGR5 and sorting ofLGR5 positive and negative population and the differences in growth between those two 2023222928 31 Aug 2023 Cells were stained as described previously and the sorting gates were set so that the highest and lowest 15% of stained cells were sorted into 200pL of culture media containing Primocin (Invitrogen). The number of sorted cells was determined based upon the number of FACS sorted events. After sorting, the cells were centrifuged 5 and plated at a density of 2000 cells / 25pL of BME. The number of organoids formed after two weeks was manually counted using an inverted light microscope. Treatment of P18T organoid with EGFRxLGR5 bispecifics For the antibody treatment experiments the culture media was modified, and did 10 not contain Gastrin or PGE2, and had a reduced concentration of EGF (2.5ng / mL). After disaggregation of organoids, Tryphan Blue staining (Sigma-Aldrich) was used to determine the number of live cells, and 5000 cells were plated / 25 pL of BME in a 48-well tissue culture plate. Each treatment had 8 technical replicates, and was cultured in 250pL of media / well. Three days after seeding single cells, the media was 15 removed and replaced with media containing the antibody treatments (2gg / mL). After 7 days from the addition of the antibodies, the plate was scanned using an Olympus ScanR using the x4 light objective, and the number of organoids quantified using ImageJ running a macro designed by the IRB microscopy facility. The experiment was repeated on three separate occasions and a two-tailed, paired 20 sample T-Test was run to assess for significant differences between treatments. RNA isolation and Q-PCR analysis of LGR5 and CK20 mRNA levels After the tissue culture plates of treated tumoroids were scanned for enumeration, the tumoroids were isolated using cell recovery solution and incubated on ice for 1 25 hour. Tumoroids were then centrifuged and re-suspended in 1 mb of TRIzol® Plus RNA Purification Kit (Life Technologies), and total RNA was extracted. After phase separation with chloroform, the upper aqueous phase was mixed with 70% ethanol and washed through RNA columns (PureLink™ RNA Mini kit, Life Technologies) according to the protocol provided by the manufacturer. RNA was quantified using 30 a Nanodrop spectrophotometer. RNA was then reverse transcribed into cDNA using the High Capacity cDNA Kit (Applied Biosystems). Quantitative real-time PCR using TaqMan probes and TaqMan Universal PCR Master Mix (both from Applied Biosystems) was used to quantify LGR5 (Hs00173664_ml) and CK20 2023222928 31 Aug 2023 (Hs00300643_ml) levels of mRNA. Differences in expression were detected using the 2—AACT method and the StepOne 2.2 plus software. Ex vivo measurement of mRNA and protein levels ofLGR5 and EGFR in PDX models 5 of different indications mRNA extracted from in vivo grown PDX tumours was used to analyse the expression levels of LGR5 and EGFR genes by RNA sequencing (RNAseq). Data from Crown Bioscience database (http: / / hubase2.crownbio.com) are expressed as log 2 conversion of fragments per kilobase million (FKPM): Table 9. In addition, tumour 10 cells extracted from in vivo grown different PDX tumours were stained with 15pg / ml of PG5816 (anti-LGR5), PG3755 (anti-EGFR) and (control) PG1337 and bound antibody was then subsequently detected with PE-labeled anti-human IgG. Table 10 shows mean fluorescence intensities for all antibody staining in several cancer indications. 15 2023222928 31 Aug 2023 Example 2: Generation of antibody panels directed to WNT pathway targets using phage antibody selections Immunization of MeMo® mice with the four different WNT targets. 5 MeMo® mice were immunized with either expression constructs encoding full length human LGR4 and LGR5 (pVaxl_hLGR4-FLAG-HA and pVaxl_hLGR5-FLAG-HA), with the extracellular domain of LGR4 or LGR5 (pVaxl_hLGR4(ECD)-GPA33-FLAG and pVaxl_hLGR5(ECD)-GPA33-FLAG) or with recombinant proteins rhLGR4-Fc, rhLGR5-Fc, rhZNRF3-Fc or rhRNF43-Fc (RND systems). Mouse sera were screened 10 for the evidence of a humoral immune response directed towards the target a FACS based assay using in-house generated Freestyle 293F cell lines that stably overexpressed the respective antigen. Figure 6 shows an example of the data. The serum IgG titers (defined as the highest serum dilution giving a staining of the Freestyle 293F cell line stably expressing the target of at least three times the MFI of serum 15 collected before immunization) of mice successfully immunized with the four WNT targets are depicted in Table 1. Mice that were shown to have mounted a significant and specific immune response towards the respective antigen were then taken out of the study and lymphoid tissues of these mice (inguinal lymph nodes and spleens) were harvested. From the obtained lymph nodes, ‘immune’ phage antibody 20 repertoires were generated by RT-PCR using IgG- and VH-specific primer pairs and cloning of the polyclonal pool of VH-encoding cDNA’s in a phagemid for the expression of Fab fragments on the surface of non-lytic phage. All libraries generated had a size of more than 10A6 clones (individual transformants) and an insert frequency of more than 80%. 25 Phage selections to generate target-specific cLC antibodies In order to generate cLC antibody panels directed to the targets hLGR4, hLGR5, hZNRF3 and hRNF43, the rhLGR4-Fc, rhLGR5-Fc, rhZNRF3-Fc, rhRNF43-Fc (RND systems) or the soluble ECD of hRNF43 or mZNRF3 (prepared in house) were 30 coated to a solid support and in-house generated synthetic cLC phage antibody repertoires were panned for binding to the coated antigens in the presence of an excess of human IgG (to prevent the selection of Fc-binding phage) essentially as described by Marks et al. (J. Mol. Biol. 1991 Dec 5;222(3):581-97). In parallel, ‘immune’ phage antibody repertoires made from successfully target-immunized 2023222928 31 Aug 2023 animals were also used for selections. Selections on coated protein were performed in microtiter plates (NUNC, maxisorp) and selections on Freestyle 293F cells that over-expressed the respective target were performed in solution; elution of bound phage was performed by a pH shock using lOOmM glycine (pH2) or lOOmM TEA 5   (pH12). After a first round of selection using synthetic phage antibody libraries, the polyclonal pool of selected clones was used to prepare phage again and phage were either panned for binding to the same antigen, or were selected on in-house generated Freestyle 293F cells stably over-expressing the respective antigen. After a single round (immune libraries), or two rounds (synthetic libraries) of selection, 10 single clones were picked and used to prepare monoclonal phage that were tested for binding their respective targets in FACS using a mix of two cell lines: the parental (antigen-negative) Freestyle 293F cell line and DiD-labelled 293F Freestyle cells that stably over-expressed the WNT target. Phage clones that recognized the (DiD-labelled) antigen-positive cell population and not the antigen-negative cells were 15 considered antigen-specific and therefore characterized further. Figure 7 shows an experiment to test selected clones for antigen specific binding to target expressing cells by FACS. Clones that were shown to be target-specific were then sequenced and grouped on the basis of their sequence identity: a ‘cluster’ of antibody clones was defined as a 20 group of antibodies sharing the same VH V-gene usage and having an identical HCDR3 sequence and HCDR3 length (Figure 17). These clones are all derived from a single ancestral clone that diversified during the in vivo immune response in the MeMo mice. A ‘super-cluster’ was defined as a group of clones sharing the same VH V-gene usage and having at least 70% sequence identity in HCDR3 and the same 25 HCDR3 length. Although this definition is arbitrary, it is probable (but not proven) that these clones also arose from a single B-cell precursor that was selected, activated and diversified during the in vivo humoral immune response. Practically, the clones in a supercluster are expected to bind the same epitope though with different affinities and / or different location on the epitope. Per super-cluster (defined 30 as described above), at least two clones were then selected to be entered into the clone validation process, during which specific binding to the target was confirmed and the sequence of the clone was verified. These numbers are based on Fab clones of which the VH has a different germline gene usage and / or HCDR3 sequence. Clones that passed the clone validation process (i.e. of which the binding to- and specificity 2023222928 31 Aug 2023 for the target was confirmed and for which the sequence was validated) were then used to re-clone the VH gene into an expression vector to produce and characterize the corresponding IgG. In total, 667 different antibodies were identified that specifically recognized one of the four targets LGR4, LGR5, ZNRF3 or RNF43, of 5 which 288 were characterized further (Table 2). All these clones were then subsequently re-cloned into bispecific cLC IgG format with a ‘dummy’ (i.e. nonrelevant, anti-TT) Fab arm to be able to characterize the mon-valent interaction of the Fab arm directed to the WNT target with its target. 10 Example 3: Antibody panel characterization. The selected Fab fragments (designated with the code MFnnnn) isolated from phage display were re-cloned into an IgGl expression vector containing DEKK mutations. To this aim, the VH-encoding cDNA was excised from the phagemid vector that was 15 used to select the antibody fragment and re-cloned into the IgG expression vector containing (KK) DEKK mutations. By co-transfection with an expression construct containing the complementary (DE) DEKK mutations and encoding a Fab fragment directed at the non-binding control antigen Tetanus Toxoid (TT: MF1337), bispecific anti- WNTxTT IgG were obtained (WNT referring to LGR4, LGR5, ZNRF3 or 20   RNF43). The bispecific IgGl panel with monovalent binding activity to the WNT targets was then produced, purified and characterized with regard to their productivity and specificity. Bispecific IgG were produced on a small scale by transient co-transfection of the plasmids encoding both Fab fragments in Freestyle 293F cells by combining different 25 Fab fragments binding the WNT targeting arm (hLGR4, hLGR5, hZNRF3 or hRNF43) in the positively charged KK vector with the control Fab fragment directed to Tetanus Toxoid in the negatively charged DE bispecific vector. After production, bispecific IgG were purified by protein-A affinity chromatography and the buffer was exchanged to PBS. Successful productions resulted in an IgGl full length antibody, 30 with a minimal concentration of 0.1 mg / ml, which were assigned a unique code (PBnnnnn; where nnnnn represents a randomly generated number) to identify the specific combination of 2 different target binding Fab fragments. 2023222928 31 Aug 2023 Successfully produced bispecific IgG were tested for binding to their respective targets in both ELISA and FACS. The ELISA was performed using rhLGR4-Fc, rhLGR5-Fc, rhZNRF3-Fc or rhRNF43-Fc at 2gg / ml or Tetanus Toxoid at 2.5gg / ml as coating. IgG were tested at a single concentration of 5gg / ml. IgG were considered 5 binding to rhLGR4-Fc, rhLGFR5-Fc, rhZNRF3-Fc or rhRNF43-Fc when the OD450nm signal observed is five times above background (OD450nm signal of negative control antibody). Additionally, a FACS analysis of the bispecific IgG directed to TT and one of the four WNT targets (hLGR4, hLGR5, hZNRF3 or hRNF43) was performed to determine specific binding to their respective WNT target. FACS analysis was 10 performed by using a DiD staining, mixing unlabeled Freestyle 239F cells (DiD-) with labeled antigen positive (hLGR4, hLGR5, hZRNF3 or hRNF43 expressing) Freestyle 293F cells (DiD+). Bispecific IgG were always tested in parallel on two mixes of cells for specificity. The bispecific IgG containing a Fab fragment directed to LGR4 or LGR5 were tested on both hLGR4 and hLGR5 overexpressing Freestyle 15   293F cells (mixed with antigen-negative Freestyle 293F cells), and the ZNRF3 and RNF43 binding antibodies were tested on both hZNRF3 and hRNF43 overexpressing Freestyle 293F cells (mixed with antigen-negative Freestyle 293F cells). Bispecific IgG were considered binding specifically to hLGR4, hLGFR5, hZNRF3 or hRNF43 when the MFI of the antigen positive population (Freestyle 293F cells stable 20 expressing hLGR4, hLGR5, hZRNF3 or hRNF43) is five times higher than the MFI of the antigen negative population (Freestyle 293F cells). 41 out of 66 LGR4 Fab fragments, 69 out of 84 LGR5 Fab fragments, 92 out of 105 ZNRF3 Fab fragments and 29 out of 33 RNF43 Fab fragments were found to bind specifically to their respective targets (hLGR4, hLGR5, hZNRF3 or hRNF43) in 25 bispecific (Biclonics®) format in both FACS and ELISA, or in a few cases FACS only (hLGR4 binding Fab fragments). 2023222928 31 Aug 2023 Characterization of the bispecific antibody panel Bispecific monovalent IgG confirmed to bind specifically to human LGR4, LGR5, ZNRF3 or RNF43 were further characterized for affinity, stability, R-Spondin3 blocking capacity and mouse orthologue cross-reactivity after which a further sub-5 selection was made. Affinity titration FACS analysis The binding antibodies were titrated in a limited antibody FACS, to rank them with regard to their affinity. Monovalent IgG directed to hLGR4, hLGR5, hZNRF3 or 10 hRNF43 (all combined with the Tetanus toxoid Fab fragment) on the cellular surface of Freestyle 293F cells overexpressing hLGR4, hLGR5, hZNRF3 or hRNF43. Each IgG was tested on its corresponding overexpressing Freestyle 293F cell line. A twofold dilution series of IgG (5gg / ml — 0,08gg / ml) was tested on a fixed number of cells (5xl05 cells / well) stable expressing the WNT targets. The mean fluorescence 15 intensity (MFI) from each individual measurement was determined by Flow Jo (FACS analysis software BD). For each IgG the MFI values were plotted against the concentration of antibody, and from these curves the area under the curves (AUC) were calculated. Based on the AUC values a ranking of the bispecific IgG was made per target. An example of the data used for affinity ranking is given in Figure 8. 20 Mouse orthologue cross reactivity of selected antibodies In order to define further the binding characteristics of the bispecific IgG, mouse orthologue cross reactivity was determined. Constructs expressing the mouse orthologues of mLgr5, mZNRF3 and mRNF43 (pEFl_mLgr5-Myc-HIS, 25 pDisplay_mZnrf3-Myc-PDGFR(TM), pDisplay_mRnf43-Myc-PDGFR(TM)) were transiently transfected in HEK293T cells. Mono-valent IgG at a concentration of 5gg / ml were used for staining and binding of IgG was analyzed by FACS. Bispecific IgG were considered mouse cross-reactive if the mean fluorescent intensity (MFI) increased two-fold compared to the non-transfected Freestyle 293F cells. 92 out of 92 30 anti-ZNRF3 IgG were cross reactive with mZnrf3; 9 out of 29 anti-RNF43 IgG were cross reactive with mRnf43 and 18 out of 69 anti-LGR5 IgG were cross reactive with the mouse Lgr5 orthologue. mLgr4 cross reactivity was tested in a ELISA on rmLgr4-Fc (RND systems) protein. Bispecific IgG were considered mLgr4 cross reactive in case the OD450nm was 5x above background (OD450nm signal of negative control 2023222928 31 Aug 2023 antibody). IgG were tested for binding at a single concentration of 5gg / ml to rmLgr4-Fc and checked for cross reactivity. 36 out of 41 anti-LGR4 IgG tested positive for mLgr4 cross reactivity. 5 R-Spondin blocking All bispecific IgG were tested in a ligand blocking ELISA to be able to test whether LGR4, LGR5, ZNRF3 or RNF43 targeting antibodies can interfere with R-Spondin3 binding. Binding of the Fc fusion proteins of the extracellular domain of the four WNT targets to coated R-Spondin3 was tested in the presence of an excess of 10 bispecific IgG directed to LGR4, LGR5, ZNRF3 or RNF43. To test bispecific IgG directed to the different targets for their ability to block the interaction of the respective Fc fusion protein with rhR-Spondin3, they were tested in a blocking ELISA. IgG were tested using a single IgG concentration of 15pg / ml. Clones were considered blocking when in two independent assays at least 50% of the 15 OD450nm signal was reduced. When only 20-50% of the OD450nm signal was reduced these clones were considered partially blocking. A subset of IgG targeting ZNRF3 (48) and RNF43 (10) and the complete LGR4 (41) and Lgr5 (69) panel, were tested for R-Spondin blocking capacity. For LGR4 3 were blocking and 5 partially blocking. For ZNRF3, 1 blocker and 1 partial blocker was identified. For RNF43 3 blockers 20 and 2 partial blockers were identified, all belonging to 2 different superclusters. For the LGR5 panel 10 IgG that partially blocked binding of R-Spondin3 were identified. An example of the data generated in the R-Spondin3 blocking assay is given in Figure 9. 25 Measuring antibody stability at 40°C In order to gain an indication of the stability of the bispecific IgG, all IgG were incubated in serum-containing medium at 40°C for 1 week and their binding in ELISA was then compared to that of bispecifics incubated in the same medium at 4°C. After 1 week, the IgG were used in an ELISA screening to determine whether 30 they retained binding to their target. Binding was determined by the percentage of OD450nm signal left after one week incubation at 40°C compared to one week incubation at 4°C. Most IgG were tested twice; when an IgG retained at least 50% of its binding in two independent assays, it was considered stable. When in the two experiments the stability varied; these IgG were considered to be partially stable, 2023222928 31 Aug 2023 and when IgG retained two times less than 50% binding, these were considered unstable. For LGR4 12 out of 41 IgG retained binding (7 partially stable, 2 undetermined; did not bind in ELISA), for LGR5 38 out of 69 IgG retained binding (7 partially stable), for ZNRF3 28 out of 92 IgG retained binding (10 partially stable) 5 and for RNF43 10 out of 29 IgG retained binding (9 partially stable). Ranking and selection of bispecific IgG After characterization was finished, the data were collected and a ranking was made based on all data obtained. Selection of Wnt targeting Fab fragments for follow up 10 functional screening was performed in the following way: Bispecific IgG which retained binding of at least 50% at 40°C were selected. The highest affinity binders were then selected. This selection contained binders with different characteristics e.g. mouse orthologue cross reactivity or R-Spondin blocking capacity. In total, 54 bispecific Fab fragments directed at the four different WNT 15 targets were selected for functional screening; for LGR4 10 out of 41 Fab fragments, for LGR5 17 out of 69 Fab fragments, for ZNRF3 18 out of 92 Fab fragments and for RNF43 9 out of 29 Fab fragments were selected (Table 3). Panel generation for functional screening 20 The selected WNT targeting Fab fragments against hLGR4, hLGR5, hZNRF3 or hRNF43 were used for the generation of a large panel of bispecific antibodies (>500 bispecifics). The selected WNT-targeting Fab fragments were combined with receptor tyrosine kinase (RTK) binding Fab fragments into a panel of bispecific IgG and produced and purified. The Fab fragments specific for EGFR and HER3 that 25 were selected block receptor activation in cell-based assays do not interfere with functionality of other Fab fragment when combined in bispecific format. Four EGFR Fab fragments MF3755, MF4280, MF3370 and MF4289 as well as four HER3 Fab fragments MF3178, MF3176, MF3125 and MF4863 were used in combination with the selected WNT-targeting Fab fragments (see Table 5 for a subselection of the 30 produced panel). Bispecifics were produced by coexpression of IgG vectors in which the WNT arm was expressed on the heavy chain containing the positively charged KK mutation and the RTK arm was expressed on the heavy chain containing the negatively charged 2023222928 31 Aug 2023 DE mutation, purified and validated for their target binding, specificity and stability. The panels of bispecifics that passed binding and stability quality control (QC) were used for functional screening (53 out of 54 WNT targeting Fab fragments passed QC). The panel of >500 purified and validated bispecific antibodies targeting 5 one of the four WNT targets (hLGR4, hLGR5, hZNRF3 or hRNF43) and an EGFR or HER3 Fab fragment or Tetanus Toxoid as a mock negative control Fab fragment control were screened for their activity towards patient-derived organoids in the functional screening assays described below. 10 Example 4: Functional screening of bispecific antibodies in colon organoids Colon organoids are derived from LGR5-positive (cancer) stem cells grown in growth factor-containing expansion medium that allows the formation of epithelial colon structures that form a functional lumen (Sato et al. 2011 Gastroenterology 141:17621772). The organoid growth, development and lumen formation depends on the 15 genetic background of the colorectal cancer cells and on the response to growth stimulating growth factors, epidermal growth factor (EGF) or Neuregulin-1 (NRG) / Heregulin (HRG). Although the morphology of CRC tumoroids from different patients differs widely, the morphological profile is consistent between the tumoroids of the same origin and they are genetically almost identical to the original tumour 20 they were derived from. High content quantitative analysis of images of cultured CRC organoids can therefore discriminate CRC organoids from different patients and can also be used to measure the morphological changes associated with activation of signaling pathways — e.g. driven by the ligands for HER receptors e.g. EGF and HRG. Similarly, inhibition of these responses by function blocking 25 antibodies or other therapeutic molecules can be measured. Image-based analysis allows changes in morphology to be measured that may be independent of cell proliferation, providing additional information on compound activity to that which is obtained from conventional proliferation assays. Compound-induced phenotypic changes therefore form the basis for the functional screening of antibodies in CRC 30 organoids. The bispecific antibodies that have been developed target either EGFR or HER3 in combination with targeting the WNT-signaling related cell surface expressed proteins LGR4, LGR5, RNF43 or ZNRF3. The screening system is designed to monitor the inhibition of tumoroid outgrowth due to the activity of bispecific 2023222928 31 Aug 2023 antibodies. This can be used for both the selection of organoids (and associated molecular profile) that are sensitive to targeted inhibition of specific pathways and also for the selection of novel molecules that are active in the organoids. 5 Selection of colon tumoroid models Colon tumoroid models used for the screens were selected based on the demonstration of morphological changes in response to EGF, HRG or WNT3A. Morphological responses to these factors were investigated in a panel of 20 tumoroids of different patient origin (Van de Wetering et al. 2015 Cell 161:933-45). First, the 10 tumoroids were expanded, split and re-seeded in 384-wells plates to analyze and document the basic morphology after 1 week of growth. Next, the same 20 tumoroids were tested for their responsiveness to growth factors, being EGF or HRG, or no growth factor present in the expansion medium. To do this, all 500 morphological features were analyzed and the changes induced by the soluble factors were 15 measured. A set of robust features was selected for each organoid that enabled measurement of the growth factor response and discrimination between growthfactor dependent tumoroid cultures and growth-factor independent tumoroid cultures (see Table 4). This demonstrated that no single feature was sufficient to optimally quantify responses in different CRC organoids. Based on these data the 20 following tumoroid lines were selected: P18T (APCmut) which is heavily EGFR signaling dependent for growth and the formation of branched lumen structures inside the tumoroids; P14T (APCmut, SMAD4mut) that shows clear morphology altering effects upon EGFR and HER3 signaling and inhibition; P19Tb (APCwt, but PIK3CA, TP53, BRAF, ARID1A, ARID2, ERBB3, POLE and RNF43 mutant) as a 25 tumoroid model that lacks APC mutations and hence depends on WNT3A for expansion; finally, P26T (APCmut, KRASmut, TP53mut and CTNNBlmut) as a model that exhibits no dependency on the presence of growth factors for expansion. In the initial screening of bispecific antibodies P26T did not show any growth factor dependency and no sensitivity towards growth factor receptor targeting antibodies, 30 and was dropped from further antibody screening. Identification of functional Fab fragments in bispecific antibodies To identify functional bispecific antibodies capable of altering the morphological characteristics of colon tumoroids, they were compared to growth conditions without 2023222928 31 Aug 2023 EGF stimulation and to the effect of EGFR / MAPK signaling inhibiting compounds (e.g. Cetuximab and Trametinib) in EGF growth conditions. Functional bispecific antibodies were defined by their ability to limit tumoroid expansion in EGF conditions in the direction of the morphological profile obtained by EGFR / MAPK 5 signaling inhibitors and / or omitting EGF from the culture medium. WNT-targeting Fab fragments that potentiated the effect of the EGFR-targeting arm are those that showed significantly enhanced growth inhibiting capacity compared to the equivalent monovalent (bispecific EGFRxTT)-targeting Fab fragment. Bispecific antibodies that only targeted LGR4, LGR5, ZNRF3 or RNF43 (in 10 combination with the non-targeting Tetanus Toxoid (TT)-Fab fragment) were compared to the negative control morphology in either no growth factor containing medium (P19Tb) or EGF or HRG containing medium (P18T and P14T) to seek potential effects of targeting WNT-signaling receptors alone. Bispecific antibodies carrying HER3-targeting Fab fragments were functionally 15 compared to growth conditions without HRG stimulation or the effect of HER3 targeting antibodies and the PI3K inhibitor in HRG conditions; Functional HER3-inhibiting bispecific antibodies were defined as those that inhibited the HRG-stimulated growth response into the same direction in Euclidean space as the MEK kinase inhibitor, Trametinib, no HRG culture conditions and / or HER3 targeting 20 reference antibodies. WNT-targeting Fab fragments that potentiated the HER3-targeting arm effect in terms of growth inhibiting effect compared to the equivalent monovalent HER3 bispecific were considered as candidate targeting Fab fragments. 2023222928 31 Aug 2023 Selection of bispecific antibody candidates in the primary screen Bispecific antibodies that, in the presence of EGF, induced a change in the morphology of P14T and P18T colon tumoroids approaching, matching or exceeding the phenotype in the absence of growth factors or presence of reference EGFR / MAPK 5 inhibitors, these antibodies were identified as potential candidates. Similarly to the EGF conditions, the antibodies tested in HRG culture conditions were marked for follow-up if the effect approached, matched or exceeded the negative control distance of the no growth factor conditions and / or reference HER3 / PI3K inhibitors. For P19Tb, which was relatively insensitive to growth factor treatment, the functional 10 antibody selection was based on calculating the distance from the negative controls marked by the morphological profile induced by Trametinib and the PI3K-inhibitor CH5132799. The bispecific panels were screened in 3 different colon tumoroids (P18T, P14T and P19Tb). The screened antibody panel tested the combinations of four different 15 EGFR-targeting Fab fragments, four different HER3-targeting Fab fragments and one anti-Tetanus Toxoid (negative control) Fab fragment with 53 different WNT-targeting Fab fragments and one TT targeting Fab fragment. Each bispecific antibody was scored for its capacity to inhibit tumoroid outgrowth. None of the TT / WNT fragment combinations inhibited tumoroid outgrowth (0 / 53). Within the 20 EGFR-targeting Fab fragment group, the MF3755 Fab fragment was most potent: 22 / 53 bispecific MF3755 / WNT Fab fragment combinations inhibited tumoroid development. The runner up EGFR-targeting fragment was MF4280 with 4 / 53 active inhibitory EGFR / WNT Fab fragment combinations. One (1 / 53) EGFR-targeting bispecific MF3370 / WNT Fab fragment combination showed inhibitory activity and 25 none (0 / 53) of the EGFR-targeting bispecific MF4289 / WNT Fab fragment combinations significantly limited the tumoroid outgrowth. Within the HER3-targeting Fab fragment containing bispecific antibody group, the MF3178 Fab fragment in combination with the WNT-targeting Fab fragments was most potent: 19 / 52 MF3178 / WNT combinations inhibited tumoroid outgrowth. Runner up HER3 30 targeting Fab fragment was MF4863 with 6 / 53 active MF4863 / WNT bispecific antibodies. Bispecific antibodies containing the HER3 targeting Fab fragments MF3125 (0 / 53) and MF3176 (0 / 52) showed no significant tumoroid outgrowth inhibition. 2023222928 31 Aug 2023 In ranking, the RTK-targeting Fab fragments that most potently combined in the bispecific IgG format with the WNT targeting Fab fragments were MF3755 as the EGFR targeting Fab fragment and MF3178 as the HER3 targeting Fab fragment. The LGR4 targeting Fab fragments MF5777 and MF5781, the LGR5 targeting Fab 5 fragments MF5790, MF5803, MF5814, MF5816, MF5817 and MF5818, the RNF43 Fab fragments MF5832 and MF5836 and the ZNRF3 targeting Fab fragments MF5850, MF5853, MF5855, MF5884 and MF5888 were identified as potential candidates to progress to the validation screen based on their functional effect on P18T, P14T and P19Tb tumoroid morphology when combined with RTK targeting 10 Fab fragments in the bispecific IgG format. The LGR4, LGR5, RNF43 and ZNRF3-targeting Fab fragments were combined with either the EGFR targeting Fab fragments MF3755, the HER3 targeting Fab fragments MF3178 or the non-targeting TT Fab fragments MF1337 and produced in new batches to confirm their activity in the follow-up validation screen. 15 Bispecific RTK / WNT antibody validation screen Because the RTK / WNT bispecific antibody candidates had shown potentially therapeutically relevant activity in both EGF and in HRG culture conditions, the validation screen of the bispecific candidate antibodies was also performed in two 20 growth factor conditions: 5ng / ml EGF or 5ng / ml HRG. Controls included wells that received culture medium without either EGF or HRG. Other controls used in growth factor conditions: Cetuximab (EGFR), PG3755 (EGFR / EGFR), Trametinib (MEK), CH5132799 (PI3K), PG3178 (HER3 / HER3), PG2863 (HER3 / HER3), PG3794 (HER3 / EGFR) and PB4522 (HER3 / EGFR). PG1337 (TT / TT) served as a negative 25 control antibody, and was referred to as negative control, along with wells receiving equal volumes of DMSO or PBS as the compound- or antibody-treated wells respectively. The antibody validation screen of 46 bispecifics was performed in 24 colon tumoroids of different patient origin, in duplicate or in quadruplicate. The set of tested colon 30 tumoroid lines consisted of 3 growth factor-dependent patient samples described in Van de Wetering et al. (2015 Cell 161:933-45): P18T, P14T and P8T and 2 growth factor independent patient samples, P19Tb and P28N. A novel set of 19 colon tumoroids were screened: 10 growth factor dependent primary colon tumoroid lines, 5 growth factor independent primary colon tumoroid lines and 4 (growth factor 2023222928 31 Aug 2023 dependent) metastatic colon tumoroid lines. The screening of the bispecific antibody candidates in the panel of 24 different patient-derived colon tumoroid lines revealed that growth-factor dependency for tumoroid outgrowth is able to identify RTK-targeting Fab fragment mediated tumor inhibition. 5 The cut-off to identify functional colon tumor inhibitory antibodies in the bispecific antibody validation screen was calculated by normalizing the morphological profile on a scale of 0 (phenotype equal to a fully growth inhibited profile) and 1 (phenotype similar to the negative controls). Every time a single antibody, at a certain dose, in a certain tumoroid line scored less than 0.5, this antibody treatment was marked as 10 showing inhibition of tumor development. The number of times an antibody, at a certain dose in either EGF or HRG culture conditions showed inhibition was scored and expressed as a percentage of the number of treated wells for that condition. This percentage was calculated in all 24 screened colon tumoroid lines. 15 The validation screen in 24 colon tumoroids identified four LGR5 targeting Fab fragments and 2 RNF43 targeting Fab fragments that potentiated the RTK-Fab fragments mediated tumor development inhibition: MF5816, MF5814, MF5818 and MF5790 as LGR5 targeting antibody Fab fragments and MF5832 and MF5836 as RNF43 targeting Fab fragments. The top ranking antibody was the EGFR / LGR5 20 bispecific antibody PB10651 composed of the targeting Fab fragments MF3755 and MF5816: Figure 10. In HRG conditions, the top ranking antibody was the HER3 / LGR5 bispecific antibody PB10748 composed of the targeting Fab fragments MF3178 and MF5816. This showed, in two independent growth factor conditions and in combination with two different RTK targeting Fab fragments, that the LGR5- 25 targeting Fab fragments MF5816 is the most potent WNT-targeting Fab fragments that enhances RTK targeting. MF5816 combined with MF3755 in PB10651 adds another level of tumor inhibition by potently reducing tumoroid growth and development, observable by further loss of lumen formation, cell shrinkage and rounding up of the nuclei. These morphological findings indicate that the 30 EGFR / LGR5 antibody PB10651 actively blocks epidermal growth factor signaling and induces a cell death response in the growth-impaired tumoroid cells: Figure 11. This morphological phenotype was not observed with EGFR targeting antibody Cetuximab nor when MF3755 was formatted as a conventional IgG. 2023222928 31 Aug 2023 Selection of the lead candidate antibody PB10651 (EGFR / LGR5 bispecific antibody (composed of the Fab fragments MF3755 5 and MF5816)) was selected as the primary lead candidate antibody in 5ng / ml EGF conditions for the following characteristics: PB10651 showed potent inhibitory effects at lOpg / ml tes...

Claims

1. A bispecific antibody comprising a variable domain that can bind anepitope on an extracellular part of Leucine Rich Repeat Containing G Protein-5 Coupled Receptor 5 (LGR5), which epitope is located within amino acid residues 21-118 of SEQ ID NO: 1, of which amino acid residues D43; G44, M46, F67, G90, and F91 are involved in binding of the antibody to the epitope; and a variable domain that can bind an epitope on an extracellular part of human EGFR of which amino acid residues 1462; G465; K489; 1491; N493; and C499 of SEQ ID NO:2 are 10 involved in binding of the antibody to the epitope.

2. The bispecific antibody of claim 1, wherein one or more of the aminoacid residue substitutions of D43A; G44A, M46A, F67A, G90A, and F91A reduces the binding of the antibody of LGR5.

153. The bispecific antibody of claim 1 or 2, wherein interaction of theantibody with LGR5 on an LGR5-expressing cell does not inhibit the binding of an Rspondin (RSPO) to LGR5 by more than 20%.20   4.         The bispecific antibody of claim 3, wherein inhibition of binding of theantibody to LGR5 is measured when the antibody and the RSPO are present in a molar ratio of 0.1 or less.

5. The bispecific antibody of any one of claims 1-4, wherein the epitope on25 LGR5 is a conformational epitope.

6. The bispecific antibody of any one of claims 1-5, wherein one or more ofthe amino acid residue substitutions selected from I462A; G465A; K489A; 1491A; N493A; and C499A reduce the binding of the antibody to human EGFR.

307. A method for treating an individual that has cancer, the methodcomprising administering the bispecific antibody of any one of claims 1-6 to the individual that has cancer.2023222928 31 Aug 20231678.        The method according to claim 7, wherein the cancer is anadenocarcinoma.5   9.        The method according to claim 7 or 8, wherein the cancer is Colorectalcancer; Pancreatic cancer; Lung cancer; Breast cancer; Liver cancer; Prostate cancer; Ovarian cancer; Cervical cancer; Endometrial cancer; Head and Neck cancer; Melanoma; Testis cancer; Urothelial cancer; Renal cancer; Stomach cancer; or Carcinoid cancer.1010. The method of any one of claims 7-9, wherein the cancer is Colorectal cancer.

11. Use of the bispecific antibody according to any one of claims 1-6, in the 15 manufacture of a medicament for the treatment of an individual in need thereof.

12. A cell system comprising the bispecific antibody according to any one of claims 1-6, and a cell that expresses the epidermal growth factor receptor EGFR and / or that expresses Leucine Rich Repeat Containing G Protein-Coupled Receptor20   5 (LGR5).

13. An in vitro method for inhibiting proliferation of a cell that expresses the epidermal growth factor receptor EGFR and / or that expresses Leucine Rich Repeat Containing G Protein-Coupled Receptor 5 (LGR5), in a system permissive 25 for proliferation of the cell, the method comprising providing the system with the bispecific antibody according to any one of claims 1-6.

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