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@ARTICLE{Lanzafame:309980,
      author       = {H. Lanzafame and I. A. Mavroeidi and K. M. Pabst and P.
                      Fragoso Costa and M. Schuler and S. Bauer and J. Kurth and
                      M. Heuschkel and J. T. Siveke$^*$ and K. Herrmann and K.
                      Kostbade and D. Kersting and S. Leyser and S. Fröhling$^*$
                      and C. E. Heilig$^*$ and R. Hamacher and W. P. Fendler},
      title        = {90{Y}-{FAPI}-46 {R}adiopharmaceutical {T}herapy in
                      {S}arcoma and {O}ther {S}olid {T}umors: {A}n {U}pdated
                      {C}ohort {A}nalysis.},
      journal      = {Journal of nuclear medicine},
      volume       = {nn},
      issn         = {0097-9058},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {DKFZ-2026-00406},
      pages        = {nn},
      year         = {2026},
      note         = {epub},
      abstract     = {Fibroblast activation protein (FAP) is highly expressed in
                      many cancers, especially sarcomas, and represents a
                      promising theranostic target. We present an updated
                      retrospective analysis of 90Y-FAP inhibitor (FAPI)-46
                      treatment in patients with sarcoma or other solid tumors.
                      Methods: We performed monocentric analysis of patients with
                      progressive sarcoma or metastatic cancer who were eligible
                      for 90Y-FAPI-46 therapy after approved treatments had been
                      exhausted and who showed high FAP expression (SUVmax, ≥10
                      in over $50\%$ of lesions on 68Ga-FAPI-46 PET). After
                      therapy, 90Y-FAPI-46 scintigraphy confirmed distribution and
                      uptake, and serial 90Y-FAPI-46 PET/CT scans measured
                      absorbed doses. Adverse events were graded by Common
                      Terminology Criteria for Adverse Events version 5.0. Tumor
                      responses were evaluated using RECIST and PERCIST. Results:
                      Thirty patients-23 $(77\%)$ with sarcoma, 3 $(10\%)$ with
                      pancreatic cancer, 1 $(3\%)$ with prostate cancer, 1 $(3\%)$
                      with gastric cancer, 1 $(3\%)$ with nonmelanoma skin cancer,
                      and 1 $(3\%)$ with cholangiocarcinoma-received a total of 77
                      cycles of 90Y-FAPI-46 radiopharmaceutical therapy between
                      June 2020 and December 2023 and were followed until death or
                      the last follow-up (April 2024). The median interval between
                      cycles was 5 mo (interquartile range [IQR], 4 mo). Of the 30
                      patients, 11 $(37\%)$ received 4 or more cycles. A median of
                      3.7 GBq (IQR, 3.7-3.8 GBq) was administered during the first
                      cycle, and a median of 7.4 GBq (IQR, 7.2-7.4 GBq) was
                      administered for subsequent cycles. The mean absorbed dose
                      was 0.48 Gy/GBq (SD, 0.06 Gy/GBq) in the kidneys and 0.04
                      Gy/GBq (SD, 0.01 Gy/GBq) in the bone marrow. Lesions with
                      the highest uptake absorbed a mean dose of 2.4 Gy/GBq (SD,
                      1.04 Gy/GBq). After treatment, hematotoxicity of any grade
                      was observed in 20 of 30 $(67\%)$ patients. Eight of 30
                      $(27\%)$ patients reached a Common Terminology Criteria for
                      Adverse Events grade of at least 3, experiencing adverse
                      events that included thrombocytopenia in 2 $(6\%),$
                      neutropenia in 2 $(6\%),$ anemia in 2 $(6\%),$ leukopenia in
                      1 $(3\%),$ and elevated γ-glutamyl transferase in 1 $(3\%)$
                      patient. RECIST (n = 25) and PERCIST (n = 20) responses
                      after treatment were assessed. Disease control according to
                      RECIST was $48\%$ (12/25), including 3 partial responses
                      $(12\%).$ Disease control correlated with extended overall
                      survival (median, 14.6 vs. 1.9 mo). Metabolic response per
                      PERCIST was observed in 12 of 20 $(60\%)$ patients.
                      Conclusion: With long-term follow-up, the favorable safety
                      profile of 90Y-FAPI-46 therapy is confirmed. Nearly half of
                      the patients demonstrated disease stabilization, almost
                      exclusively in sarcomas. Our findings support the role of
                      FAP-directed radiopharmaceutical therapy in patients with
                      metastatic sarcoma.},
      keywords     = {90Y-FAPI-46 (Other) / radiopharmaceutical therapy (Other) /
                      sarcomas (Other) / theranostics (Other)},
      cin          = {ED01 / B340 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331 / I:(DE-He78)B340-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {312 - Funktionelle und strukturelle Genomforschung
                      (POF4-312)},
      pid          = {G:(DE-HGF)POF4-312},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41714122},
      doi          = {10.2967/jnumed.125.271135},
      url          = {https://inrepo02.dkfz.de/record/309980},
}