SNMMI: Study Finds FAP-Targeted Radioligand Therapy Beneficial for Patients with Advanced Sarcomas

Can fibroblast activation protein (FAP)-targeted treatment have an impact in controlling disease progression with advanced sarcomas?

In new research, presented at the 2024 Society of Nuclear Medicine and Molecular Imaging (SNMMI) Annual Meeting, researchers reviewed data from 30 patients who were treated with ⁹⁰Y-FAPI-46 radioligand therapy. According to the study, 77 percent of the cohort (23 patients) had sarcomas, 10 percent (3 patients) had advanced metastatic pancreatic cancer and the remaining four patients had prostate cancer, gastric cancer, squamous cell carcinoma and cholangiocarcinoma. The study authors noted a total of 77 treatment cycles with ⁹⁰Y-FAPI-46 over a 3.5-year period.

Imaging control of disease was obtained in 44 percent of patients (10/23) assessed with RECIST (version 1.1) criteria and 50 percent of patients (10/20) evaluated via PERCIST guidelines, according to the study authors. They pointed out that 35 percent of the patients who achieved disease control as per RECIST criteria had sarcomas.

Here one can see baseline (A and upper row) 18F-FDG images and interim images after two cycles of 90Y-FAPI-46 radioligand therapy (B and lower row) for a patient treated for sarcoma of the pelvis. (Images courtesy of SNNMI.)

While adverse hematological events were reported in 60 percent of the cohort (18/30), the researchers noted that six patients (20 percent) had grade 3 adverse events that were all attributed to hematological toxicity. The study authors added that none of the patients in the cohort reached critical organ radiation dose levels during treatment with ⁹⁰Y-FAPI-46.

“The results of our study have demonstrated good tolerance and promising efficacy, particularly in controlling disease progression in patients with advanced sarcoma,” noted Helena Lanzafame, M.D., who is affiliated with the Department of Nuclear Medicine at University Hospital Essen in Essen, Germany. “This indicates a specific benefit for this patient group, who often have limited treatment options due to the aggressive nature and poor prognosis associated with metastatic stage disease. ⁹⁰Y-FAPI-46 radioligand therapy represents a promising approach for these patients, potentially improving survival rates and quality of life.”

Noting the modality’s enhanced visualization with imaging of sarcomas and malignant solid tumors, the study authors maintained the use of 90Y-FAPI-46 radioligand therapy may provide significant promise in precision imaging and treatment.

“FAP-targeted radioligand therapy represents a groundbreaking approach in cancer treatment. Its ability to selectively target electively to FAP-expressing cells and deliver localized radiation, minimizing off-target effects, has the potential to offer significant advantages over traditional therapies,” added Dr. Lanzafame.

Reference

1. Lanzafame H, Pabst K, Mavroeidi IA, et al. 90Y-FAPI-46 radioligand therapy for advanced-stage solid tumors: a retrospective cohort analysis. Presented at the 2024 Society of Nuclear Medicine and Molecular Imaging Annual Meeting, June 8-11, Toronto, Canada. Available at: https://www.xcdsystem.com/snmmi/program/10OD8Tq/index.cfm . Accessed June 8, 2024.