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Related Concept Videos

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Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
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90Y-FAPI-46 Radiopharmaceutical Therapy in Sarcoma and Other Solid Tumors: An Updated Cohort Analysis.

Helena Lanzafame1,2, Ilektra A Mavroeidi2,3, Kim M Pabst4,2

  • 1Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, Essen, Germany; helena.lanzafame@uk-essen.de.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|February 19, 2026
PubMed
Summary

90Y-FAP inhibitor (FAPI)-46 radiopharmaceutical therapy shows a favorable safety profile in patients with advanced cancers, particularly sarcomas. Disease stabilization was observed in nearly half of patients, supporting its role in sarcoma treatment.

Keywords:
90Y-FAPI-46radiopharmaceutical therapysarcomastheranostics

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Area of Science:

  • Nuclear Medicine
  • Oncology
  • Radiopharmaceutical Therapy

Background:

  • Fibroblast activation protein (FAP) is a key target in many cancers, especially sarcomas.
  • 90Y-FAP inhibitor (FAPI)-46 offers a theranostic approach for FAP-expressing tumors.

Purpose of the Study:

  • To evaluate the long-term safety and efficacy of 90Y-FAPI-46 therapy in patients with advanced sarcoma and other solid tumors.
  • To assess tumor response and survival outcomes following 90Y-FAPI-46 treatment.

Main Methods:

  • Retrospective analysis of 30 patients with progressive or metastatic cancer and high FAP expression (SUVmax, ≥10).
  • Patients received 90Y-FAPI-46 therapy after exhaustion of approved treatments.
  • Tumor response assessed by RECIST and PERCIST; adverse events graded by CTCAE v5.0.

Main Results:

  • 48% disease control (RECIST) and 60% metabolic response (PERCIST) observed.
  • Disease control correlated with improved overall survival (14.6 vs. 1.9 months).
  • Favorable safety profile confirmed, with manageable hematotoxicity (any grade in 67%, grade ≥3 in 27%).

Conclusions:

  • 90Y-FAPI-46 therapy demonstrates a favorable long-term safety profile.
  • Disease stabilization, primarily in sarcomas, supports FAP-directed radiopharmaceutical therapy.
  • 90Y-FAPI-46 is a promising therapeutic option for metastatic sarcoma patients.