Trop2 immunoPET/CT in clinical practice: facts and challenges

Trop2 (Trophoblast cell surface antigen 2) is a crucial tumor-associated antigen that is overexpressed in various epithelial-derived cancers. Thus, it has become a key target for molecular imaging and therapy. Immuno-positron emission tomography/computed tomography (immunoPET/CT), which combines the high specificity of antibody-based tracers with the high resolution of PET/CT, provides a new approach for noninvasive target visualization, accurate cancer diagnosis, staging, restaging, patient selection, and response monitoring in clinical cancer management. This review covers the design of tracers, preclinical progress, and translational applications of Trop2-targeted immunoPET/CT, highlighting its role in Trop2-specific cancer diagnosis and patient stratification, as well as its potential to guide and improve Trop2-targeted therapies. We also discuss current challenges and future directions for development, including the integration of multimodal imaging with personalized medicine. Trop2-targeted immunoPET/CT has significant potential to transform clinical practice and to improve precision oncology when combined with Trop2-targeted therapies.