Fibroblast activation protein inhibitor radiotheranostics for imaging activated tumor stroma and guiding radionuclide therapy

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Fibroblast activation protein (FAP) is expressed by activated fibroblasts and vascular-associated stromal cells in tumors.
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Radiolabeled FAP inhibitors (FAPIs) enable PET imaging of FAP-accessible activated stroma, enhancing tumor-cell metabolic imaging.
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FAPI PET provides high lesion-to-background contrast in low-FDG-avid tumors and is particularly useful in gastrointestinal cancers.
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FAPI uptake is not tumor-specific and can occur in various fibro-inflammatory conditions, requiring careful interpretation.
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Current evidence supports FAPI PET as a complementary imaging method for FAP-targeted radionuclide therapy, not a universal replacement.

Frontiers In Oncology

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