Recent Clinical Implications of FAPI: Imaging and Therapy.

Area of Science:

• Oncology
• Radiology
• Molecular Imaging

Background:

• Fibroblast activation protein (FAP) is overexpressed in cancer-associated fibroblasts (CAFs) and in various nonmalignant diseases.
• FAP is crucial in the tumor microenvironment, influencing proliferation, invasion, angiogenesis, immunosuppression, and drug resistance.

Purpose of the Study:

• To provide a comprehensive overview of FAP's role in cancer and nonmalignant diseases.
• To discuss FAP inhibitors for imaging and therapy, including clinical implications and challenges.
• To present imaging results of 68Ga-FAPI-46 in nonmalignant conditions.

Main Methods:

• Review of FAP's function in disease pathophysiology.
• Analysis of radiolabeled FAP inhibitors, focusing on small molecules.
• Clinical imaging and biodistribution study of 68Ga-FAPI-46 in patients with nonmalignant diseases.

Main Results:

• FAP-targeted imaging, particularly PET, demonstrates high sensitivity and specificity for detecting FAP-expressing tumors.
• Cardiac FAP-targeted imaging may serve as a novel biomarker for managing left ventricle remodeling.
• 68Ga-FAPI-46 imaging showed potential in nonmalignant conditions like interstitial lung disease and myocardial infarction.

Conclusions:

• FAP inhibitors represent a promising target for cancer and nonmalignant disease diagnosis and treatment.
• FAP-targeted imaging can improve tumor detection, staging, and treatment monitoring.
• Further research into FAP inhibitors holds significant prospects for personalized medicine.