Fibroblast Activation Protein–Targeted PET Imaging of Metastatic Castration-Resistant Prostate Cancer Compared With 68Ga-PSMA and 18F-FDG PET/CT

5073 Background: Cabo is a multitargeted kinase inhibitor that has demonstrated complete and partial responses in mCRPC as assessed byTc-99 MDP bone scintigraphy. FDG and FDHT PET/CT demonstrate glucose metabolism and androgen receptor binding, respectively. We are exploring these tracers as response biomarkers in mCRPC treated with cabo. Methods: Patients (pts) treated with cabo were scanned with FDHT and FDG PET at baseline and after 6, 12, and 24 weeks (wks) of treatment. 5 index lesions were selected at baseline for each PET modality. The hottest slices from each were averaged (SUVmaxavg) and measured on post-treatment scans. The concordance of the post-treatment alterations of the two tracers (rise vs. decline) was examined, as were PSA alterations. Results: All 16 pts had FDG avid and 15 had FDHT avid disease. Baseline median FDHTmaxavg was 10.84 (3.52 – 18.52) and FDGmaxavg was 6.26 (2.74 – 14.7). Post-treatment alterations are described (Table). Conclusions: Most pts with mCRPC demonstrate diminution of FDHT uptake after 6 and 12 wks of treatment with cabo. These declines are matched by FDG 50-60% of the time, and correlate with PSA declines even less frequently. The etiology of the extent and degree of FDHT declines, and lack of concordance with post-treatment PSA changes, warrant further investigation, and correlation with other imaging modalities and clinical outcomes. Clinical trial information: NCT00588185. [Table: see text]

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Imaging fibroblast activation protein in liver cancer: a single-center post hoc retrospective analysis to compare [68Ga]Ga-FAPI-04 PET/CT versus MRI and [18F]-FDG PET/CT

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-020-05095-0 ◽

2020 ◽

Author(s):

Wei Guo ◽

Yizhen Pang ◽

Lanlin Yao ◽

Liang Zhao ◽

Chunlei Fan ◽

...

Keyword(s):

Liver Cancer ◽

Retrospective Analysis ◽

Fdg Pet ◽

Fibroblast Activation Protein ◽

Single Center ◽

Fibroblast Activation ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Post Hoc

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High fibroblast-activation-protein expression in castration-resistant prostate cancer supports the use of FAPI-molecular theranostics

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05423-y ◽

2021 ◽

Author(s):

Claudia Kesch ◽

Leubet Yirga ◽

Katharina Dendl ◽

Analena Handke ◽

Christopher Darr ◽

...

Keyword(s):

Prostate Cancer ◽

Androgen Deprivation Therapy ◽

Fibroblast Activation Protein ◽

Significant Rise ◽

Androgen Deprivation ◽

Castration Resistant Prostate Cancer ◽

H Index ◽

Fibroblast Activation ◽

Castration Resistant ◽

Pet Ct

Abstract Purpose To evaluate fibroblast-activation-protein (FAP) expression in different clinical stages of prostate cancer (PC) with regards to utility of [68 Ga]Ga-FAPI-04 PET/CT imaging in patients with castration-resistant PC (CRPC). Methods Tissue microarrays (TMAs) were constructed from prostatic tissue from 94 patients at different stages of PC (primary PC, patients undergoing neoadjuvant androgen deprivation therapy, CRPC, and neuroendocrine PC (NEPC)) and were stained with anti-FAP monoclonal antibody. A positive pixel count algorithm (H-Index) was used to compare FAP expression between the groups. Additionally, three men with advanced CRPC or NEPC underwent [68 Ga]Ga-FAPI-04 PET/CT, and PET positivity was analyzed. Results The mean H-index for benign tissue, primary PC, neoadjuvant androgen deprivation therapy before radical prostatectomy, CRPC, and NEPC was 0.018, 0.031, 0.042, 0.076, and 0.051, respectively, indicating a significant rise in FAP expression with advancement of disease. Corroborating these findings [68 Ga]Ga-FAPI-04 PET/CT was highly positive in men with advanced CRPC. Conclusion Increased FAP tissue expression supports the use of FAP inhibitor (FAPI)-molecular theranostics in CRPC.

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Fibroblast activation protein targeted PET/CT with 68Ga-FAPI for imaging IgG4-related disease: comparison to 18F-FDG PET/CT

Journal of Nuclear Medicine ◽

10.2967/jnumed.120.244723 ◽

2020 ◽

pp. jnumed.120.244723 ◽

Cited By ~ 2

Author(s):

Yaping Luo ◽

Qingqing Pan ◽

Huaxia Yang ◽

Linyi Peng ◽

Wen Zhang ◽

...

Keyword(s):

Fdg Pet ◽

Fibroblast Activation Protein ◽

Fibroblast Activation ◽

Related Disease ◽

Igg4 Related Disease ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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The prognostic power of 18F-FDG PET/CT extends to estimating systemic treatment response duration in metastatic castration-resistant prostate cancer (mCRPC) patients

Prostate Cancer and Prostatic Diseases ◽

10.1038/s41391-021-00391-8 ◽

2021 ◽

Author(s):

Matteo Bauckneht ◽

Francesco Bertagna ◽

Maria Isabella Donegani ◽

Rexhep Durmo ◽

Alberto Miceli ◽

...

Keyword(s):

Prostate Cancer ◽

Treatment Response ◽

Fdg Pet ◽

Prognostic Value ◽

Systemic Treatment ◽

Response Duration ◽

Castration Resistant Prostate Cancer ◽

Castration Resistant ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Background We aimed to test whether the prognostic value of 18 F‐Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in metastatic castration-resistant prostate cancer (mCRPC) extends to the estimation of systemic treatment response duration. Methods mCRPC patients submitted to FDG-PET/CT in four Italian centers from 2005 to 2020 were retrospectively enrolled. Clinical and biochemical data at the time of imaging were collected, and SUV max of the hottest lesion, total metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated. The correlation between PET- and biochemical-derived parameters with Overall Survival (OS) was analysed. The prediction of treatment response duration was assessed in the subgroup submitted to FDG-PET/CT in the six months preceding Chemotherapy (namely Docetaxel or Cabazitaxel, 24 patients) or Androgen-Receptor Targeted Agents (ARTA, namely Abiraterone or Enzalutamide, 20 patients) administration. Results We enrolled 114 mCRPC patients followed-up for a median interval lasting 15 months. While at univariate analysis, prostate-specific antigen (PSA), Alkaline Phosphatase (ALP), MTV, and TLG were associated with OS, at the multivariate Cox regression analysis, the sole MTV could independently predict OS (p < 0.0001). In the subgroup submitted to FDG-PET/CT before the systemic treatment initiation, PSA and TLG could also predict treatment response duration independently (p < 0.05). Of note, while PSA could not indicate the best treatment choice, lower TLG was associated with higher success rates for ARTA but had no impact on chemotherapy efficacy. Conclusions FDG-PET/CT’s prognostic value extends to predicting treatment response duration in mCRPC, thus potentially guiding the systemic treatment selection.

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