AbstractBackground:HER2-low expressing cancers, including gastric and breast cancers, have historically been categorized as HER2-negative, limiting targeted therapy options. To address this, we developed KMD111, a novel HER2-targeted drug delivery platform using mesoporous silica nanoparticles (MSNs) loaded with a potent anticancer drug and coated with HER2-targeting affibody proteins via a glutathione-sensitive GST-GSH bio-linker. KMD111 demonstrated high tumor-targeting efficiency, superior anti-tumor efficacy, and a favorable safety profile in preclinical models, providing stability in the bloodstream and selective drug release regulated by GSH concentrations in the tumor microenvironment.Methods:KMD111 was synthesized by conjugating HER2-targeting affibody proteins to drug-loaded MSNs. Binding affinity and internalization were assessed in HER2-expressing cancer cell models. Anti-tumor efficacy was evaluated in gastric and breast cancer xenografts, while mechanistic studies examined cell cycle arrest, apoptosis activation, and HER2 signaling inhibition. Safety was evaluated through macrophage uptake, histopathological analysis, and toxicity testing.Results:KMD111 demonstrated efficient drug loading and GSH-responsive drug release in vitro, with high tumor-targeting efficiency and strong internalization in HER2-expressing cancer cells. It exhibited superior anti-tumor efficacy compared to Enhertu®, Kadcyla®, and Cyramza® and effectively triggered cell cycle arrest and apoptosis activation through a potent anticancer drug. KMD111 also showed a favorable safety profile, including minimal macrophage uptake, negligible myelosuppression, and no significant off-target toxicity, with a therapeutic index exceeding five times the effective dose.Conclusion:KMD111 demonstrates robust targeting, high therapeutic efficacy, and a favorable safety profile in HER2-expressing gastric and breast cancer models. This innovative approach, leveraging a glutathione-regulated bio-linker for enhanced delivery and tumor specificity, represents a promising foundation for next-generation drug delivery systems targeting HER2-expressing malignancies.Citation Format:Jong Kook Rho, Gyeong Hee Lee, Seung Min Byun, Hyo Kyoung Park, JinBeam Kim, YoungKuk Yun, Myung Hoon Kim. Development and evaluation of KMD111: A HER2-targeted novel drug delivery system for gastric and breast cancer therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1801.