The present invention provides multispecific molecules, e.g., comprising more than one ISVD or Nanobody, that bind to PD1 and CTLA4. These molecules have been engineered so as to reduce the incidence of binding by pre-existing antibodies in the bodies of a subject administered such a molecule. Methods for increasing immune response, treating cancer and/or treating an infectious disease with such molecules are provided.本發明提供結合至PD1及CTLA4之多特異性分子,例如包含多於一種ISVD或奈米抗體。此等分子已經工程改造以減少投與此分子之個體身體中預先存在抗體之結合發生。提供用此分子增加免疫反應、治療癌症及/或治療感染性疾病之方法。