Cancer-Associated Fibroblasts: Clinical Applications in Imaging and Therapy.

Area of Science:

• Oncology
• Tumor Microenvironment Biology
• Cancer Therapeutics

Background:

• Cancer-associated fibroblasts (CAFs) are key components of the tumor microenvironment, influencing tumor progression through matrix remodeling, immune evasion, angiogenesis, and metastasis.
• Fibroblast activation protein (FAP) is highly expressed on a subset of CAFs in many solid tumors and is linked to poor prognosis.
• FAP is emerging as a significant target for novel cancer imaging and therapeutic strategies.

Purpose of the Study:

• To provide a clinically focused review of CAFs within the tumor microenvironment.
• To highlight key fibroblast markers, their prognostic associations, and their utility in imaging and targeted therapy.
• To explore emerging strategies for targeting CAFs, including non-FAP molecules and subtype-specific approaches.

Main Methods:

• Literature review of CAFs, FAP expression, and targeting strategies in solid tumors.
• Analysis of prognostic associations between fibroblast markers and cancer outcomes.
• Examination of current preclinical and clinical investigations of FAP-targeting agents.

Main Results:

• CAFs exhibit diverse subtypes and play critical roles in promoting tumor growth and spread.
• Elevated FAP levels correlate with adverse prognosis in numerous cancer types.
• Multiple FAP-targeting modalities are under investigation for cancer treatment and imaging.

Conclusions:

• FAP represents a promising therapeutic and imaging target for solid tumors.
• Targeting CAFs, particularly with selective and subtype-specific strategies, holds potential for advancing cancer care.
• Radiologic imaging and targeted stromal therapies are evolving fields in oncology.