TY  - JOUR
AU  - Kessler, Lukas
AU  - Schwaning, Felix
AU  - Metzenmacher, Martin
AU  - Pabst, Kim M
AU  - Opitz, Marcel
AU  - Wiesweg, Marcel
AU  - Aigner, Clemens
AU  - Ploenes, Till
AU  - Boeloekbas, Servet
AU  - Doerr, Fabian
AU  - Stuschke, Martin
AU  - Umutlu, Lale
AU  - Nader, Michael
AU  - Theegarten, Dirk
AU  - Eberhardt, Wilfried E
AU  - Schuler, Martin
AU  - Herrmann, Ken
AU  - Fendler, Wolfgang P
AU  - Kersting, David
AU  - Hautzel, Hubertus
TI  - Prognostic Value of Fibroblast Activation Protein-Directed PET Imaging in Pleural Mesothelioma.
JO  - Journal of nuclear medicine
VL  - nn
SN  - 0097-9058
CY  - New York, NY
PB  - Soc.
M1  - DKFZ-2026-00070
SP  - nn
PY  - 2026
N1  - #DKTKZFB9# / #NCTZFB26# / epub
AB  - High expression of fibroblast activation protein (FAP) has been associated with inferior survival in several tumor entities. Novel 68Ga-radiolabeled FAP inhibitors (68Ga-FAPIs) allow noninvasive measurement of FAP, which enables the development of prognostic imaging parameters from 68Ga-FAPI PET/CT. In this study, we compared the prognostic value of 68Ga-FAPI-46 with 18F-FDG PET in a cohort of patients with malignant pleural mesothelioma from the FAPI PET observational trial (NCT04571086). Methods: Between May 2020 and January 2024, 49 patients with suspected or proven malignant mesothelioma were recruited, 39 of whom were eligible for data analysis. All patients underwent 68Ga-FAPI-46 and 18F-FDG PET/CT less than 4 wk apart. Tumor burden was measured semiautomatically, and SUVmax, SUVmean, and volumetric parameters (metabolic tumor volume [MTV], total lesion glycolysis/total lesion fibroblast activation, and total tumor SUV) were calculated. The FAP immunoreactive score (IRS) was calculated for tumor samples from a subset of patients (n = 19). Overall survival and progression-free survival were assessed per revised mRECIST (version 1.1). Survival analyses were performed with univariate and multivariate Cox regression and with Kaplan-Meier curves for clinical and imaging parameters, stratified by median. Results: Univariate analysis showed significant survival differences for all volumetric parameters for 68Ga-FAPI-46 and 18F-FDG (e.g., 68Ga-FAPI-46 MTV, 262 d vs. 737 d; P = 0.008 vs. 18F-FDG MTV, 336 d vs. 760 d; P = 0.012). Multivariate analysis revealed that MTV was an independent prognostic marker for 68Ga-FAPI-46 (hazard ratio, 4.44; 95
KW  - FAPI (Other)
KW  - cancer imaging (Other)
KW  - fibroblast activation protein (Other)
KW  - mesothelioma (Other)
KW  - theranostic (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:41506801
DO  - DOI:10.2967/jnumed.125.270906
UR  - https://inrepo02.dkfz.de/record/307575
ER  -