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Updated: Jan 7, 2026
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Automated Preparation of [68Ga]Ga-3BP-3940 on a Synthesis Module for PET Imaging of the Tumor Microenvironment
Published on: April 25, 2025
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Current status of FAP therapy in solid tumors
Sophie C Siegmund1, Emil Novruzov2, Eduards Mamlins2
1Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
Seminars in Nuclear Medicine
|December 27, 2025
Summary
Fibroblast activation protein (FAP) targeted imaging complements FDG PET/CT for improved cancer diagnosis, especially in tumors with low glucose metabolism. FAP theranostics show promise for future cancer therapy, offering new hope for systemic disease treatment.
Area of Science:
- Nuclear medicine and molecular imaging
- Oncology and cancer diagnostics
- Radiopharmaceutical development
Background:
- Fibroblast activation protein (FAP) ligands are emerging as novel radiopharmaceuticals for cancer imaging and therapy.
- FAP-targeted imaging, including FAPI PET/CT, is increasingly recognized as a valuable complement to established FDG PET/CT.
- While FDG PET/CT is standard, FAP imaging addresses limitations in detecting tumors with low glucose metabolism.
Purpose of the Study:
- To review recent advancements in FAP-targeted radiopharmaceuticals for both imaging and therapeutic applications in oncology.
- To highlight the complementary role of FAP imaging alongside FDG PET/CT in specific cancer subtypes.
- To discuss the current status and future potential of FAP theranostics in cancer treatment.
Main Methods:
- Review of current literature on FAP-ligands, including small molecules (e.g., FAPI-46, FAPI-74) and peptides (e.g., FAP-2286).
- Analysis of clinical applications and ongoing trials for FAPI PET/CT and SPECT imaging.
- Evaluation of FAP-derivatives in early-stage therapeutic development (theranostics).
Main Results:
- FAPI PET/CT has demonstrated success in imaging various cancers like pancreatic, gastroesophageal, and lung adenocarcinomas, often outperforming FDG PET/CT in specific cases.
- Several FAP imaging agents (e.g., FAPI-04, FAPI-46, FAPI-74, FAPI-34) are already in clinical practice.
- FAP-targeted therapeutics are in early clinical trials (Phase I), showing potential for treating systemic diseases.
Conclusions:
- FAP-targeted imaging is a valuable tool that enhances diagnostic accuracy by complementing FDG PET/CT, particularly in challenging tumor types.
- FAP theranostics represent a promising frontier for cancer treatment, offering innovative therapeutic strategies beyond standard care.
- Continued research and clinical trials are crucial for realizing the full potential of FAP-based theranostics in personalized oncology.
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