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Related Experiment Video

Updated: May 5, 2026

An Automated Radiosynthesis of [68Ga]Ga-FAPI-46 for Routine Clinical Use
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FAP-Targeted Theranostics in Advanced Sarcoma: A Pilot Study of ⁶⁸Ga-FAPI-46 Imaging and ¹⁷⁷Lu-FAPI-2286 Therapy.

Narges Jokar1, Malik E Juweid2,3, Esmail Jafari1

  • 1Department of Nuclear Medicine, The Persian Gulf Nuclear Medicine Research Center, The Persian Gulf Biomedical Research Institute, Molecular Imaging, and Theranostics, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.

Clinical Nuclear Medicine
|May 4, 2026
PubMed
Summary

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This summary is machine-generated.

¹⁷⁷Lu-FAPI-2286 radioligand therapy (RLT) showed safety and disease stabilization in advanced sarcoma patients. ⁶⁸Ga-FAPI-46 PET/CT offers better delineation of FAP-rich tumors than ¹⁸F-FDG PET/CT, though with smaller volumes.

Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiopharmaceutical Therapy

Background:

  • Sarcomas are aggressive cancers with poor prognoses, especially in advanced stages.
  • Fibroblast activation protein (FAP) is a promising target due to its high expression in sarcoma tumors.
  • Conventional therapies are often ineffective for advanced metastatic sarcomas.

Purpose of the Study:

  • To assess the safety and efficacy of ¹⁷⁷Lu-FAPI-2286 radioligand therapy (RLT) in patients with advanced metastatic sarcoma.
  • To compare the diagnostic performance of ⁶⁸Ga-FAPI-46 PET/CT with ¹⁸F-FDG PET/CT for sarcoma imaging.

Main Methods:

  • An exploratory single-center study involving 6 patients with treatment-refractory metastatic sarcoma.
  • Patients received 2-4 cycles of ¹⁷⁷Lu-FAPI-2286 RLT after baseline ⁶⁸Ga-FAPI-46 and ¹⁸F-FDG PET/CT scans.
Keywords:
177Lu-FAPI-228668Ga-FAPIfibroblast activation protein (FAP)radioligand therapysarcoma

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  • Safety, toxicity (CTCAE v5.0), and treatment response (PERCIST) were evaluated, alongside quantitative imaging metrics.

    • Main Results:

    • ¹⁷⁷Lu-FAPI-2286 RLT was well-tolerated with no severe toxicities; only low-grade hematological events occurred.
    • No significant differences were found between ⁶⁸Ga-FAPI-46 and ¹⁸F-FDG PET/CT in most quantitative parameters, though ¹⁸F-FDG showed slightly higher metabolic tumor volumes.
    • Disease stabilization was observed in some patients, with one showing a mixed response; median overall survival was 4 months.

    Conclusions:

    • ¹⁷⁷Lu-FAPI-2286 RLT is a safe and tolerable treatment option for heavily pretreated sarcoma patients, potentially stabilizing disease.
    • ⁶⁸Ga-FAPI-46 PET/CT excels at visualizing FAP-positive tumor regions, offering superior delineation compared to ¹⁸F-FDG PET/CT.
    • Further prospective multicenter studies are needed to validate these findings and refine FAP-targeted theranostic approaches in sarcoma.