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Anti-HER2 CAR T cells are an investigational cell-based immunotherapy consisting of T cells (typically autologous) genetically engineered to express a chimeric antigen receptor (CAR) that recognizes Human Epidermal Growth Factor Receptor 2 (HER2/ErbB2). The CAR construct generally incorporates an scFv binding domain (often derived from the monoclonal antibody trastuzumab) linked to intracellular signaling domains, such as CD3ζ and co-stimulatory molecules like CD28 or 4-1BB. Upon binding to HER2-expressing tumor cells, these CAR T cells undergo activation and expansion, leading to direct tumor cell lysis. This therapy is being evaluated for various HER2-positive solid tumors, including glioblastoma, breast cancer, gastric cancer, and sarcomas. Clinical development faces challenges such as the immunosuppressive tumor microenvironment and potential 'on-target, off-tumor' toxicities in organs with low HER2 expression, such as the lungs.
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