Posttreatment ⁶⁸Ga-FAP-2286 PET/CT Parameters for Response and Survival Assessment After ¹⁷⁷Lu-FAP-2286 Radioligand Therapy in Advanced Solid Tumors.

Authors

Min Fan, Zhihan Yao, Xinyue Guo, Meiling Hu, Fengyu Zhang, Guangfu Liu, Chunyin Zhang, Jie Zhao, Yue Chen

Published in

Clinical nuclear medicine. Jul 03, 2026. Epub Jul 03, 2026.

Abstract

Fibroblast activation protein (FAP) is highly expressed in cancer-associated fibroblasts and represents an emerging target for radioligand therapy (RLT). This study aimed to evaluate treatment outcomes of ¹⁷⁷Lu-FAP-2286 and to investigate whether changes in quantitative parameters on ⁶⁸Ga-FAP-2286 PET/CT are associated with treatment response and survival in patients with advanced solid tumors.
In this single-center retrospective study, patients with advanced solid tumors who completed 2 cycles of ¹⁷⁷Lu-FAP-2286 therapy and underwent both baseline and posttreatment ⁶⁸Ga-FAP-2286 PET/CT (8-16 wk after therapy) were included. Maximum standardized uptake value (SUVmax) and total tumor volume (TTV) were quantified using semiautomatic whole-body segmentation. Relative changes (ΔSUVmax and ΔTTV) were calculated. RECIST 1.1 served as the clinical reference standard. Receiver operating characteristic analysis assessed the ability of PET-derived changes to discriminate progressive disease. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier analysis and Cox proportional hazards models.
Thirty patients (median age, 65 y; range, 23-78 y) completed 2 cycles of ¹⁷⁷Lu-FAP-2286 therapy. According to RECIST 1.1, partial response, stable disease, and progressive disease occurred in 6 (20.0%), 11 (36.7%), and 13 (43.3%) patients, respectively. SUVmax and TTV decreased in 46.7% of patients. ΔSUVmax demonstrated moderate discrimination for RECIST-defined PD (AUC 0.72, P=0.04). Patients with ΔSUVmax <30% had significantly longer PFS than those with ΔSUVmax ≥30% (median 10.3 vs. 4.4 mo; log-rank P<0.001). Median OS was not reached in the ΔSUVmax <30% group compared with 9.8 months in the ΔSUVmax ≥30% group (log-rank P=0.003). In multivariable analysis, ΔSUVmax remained independently associated with PFS (HR: 5.2, 95% CI 1.5-7.8; P=0.010) and OS (HR: 4.3, 95% CI: 1.3-14.1; P=0.015).
In patients with advanced solid tumors treated with 2 cycles of ¹⁷⁷Lu-FAP-2286, posttreatment changes in SUVmax on ⁶⁸Ga-FAP-2286 PET/CT were associated with treatment response and survival, suggesting potential utility as an imaging biomarker for early response assessment and prognostic stratification.

PMID:
42397089
Bibliographic data and abstract were imported from PubMed on 03 Jul 2026.

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