Objective:

Radioligand therapy (RLT) is an emerging modality that combines targeted therapy with radiation-induced cytotoxicity. This study investigates the efficacy and safety of

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Lu-fibroblast activation protein (FAP)-2286 RLT in patients with advanced lung cancer. A comprehensive assessment was conducted through clinical trials and patient outcome analyses to evaluate the therapeutic potential of this treatment

aiming to improve the prognosis of patients with advanced lung cancer.

Methods:

The study included patients with advanced lung cancer treated with

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Lu-FAP-2286 RLT in the Affiliated Hospital of Southwest Medical University from September 2022 to April 2024. Baseline scans using

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Ga-FAP-2286 positron emission tomography (PET)/ computed tomography (CT) confirmed high expression of FAP within the lesions. Each treatment cycle administered approximately 200 mCi (7.4 GBq) of

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Lu-FAP-2286 via intravenous infusion over 4 h

with intervals of 8-12 weeks between cycles

for a total of 4-6 cycles. The evaluation of safety and efficacy included laboratory tests

adverse event documentation

and assessments according to response evaluation criteria in solid tumor (RECIST) 1.1 and adopted PET response criteria in solid tumor (PERCIST) 1.0 criteria. Data analysis was performed using SPSS version 26.0

with paired sample t-tests applied to compare pre- and post-treatment differences following normality tests.

Results:

Among the 10 patients included in the study (8 males and 2 females

aged 53-73)

treatment cycles varied: one patient received six cycles

three patients received four cycles

one patient received three cycles

four patients received two cycles

and one patient received only one cycle. The median follow-up pe

riod was 13 months. Treatment with

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Lu- FAP-2286 was well-tolerated

with the primary adverse effects being fatigue and abdominal distension. No severe hematological toxicity or significant impairment of liver and kidney function was observed. Efficacy evaluation revealed a partial response (PR) rate of 30.0%

a stable disease (SD) rate of 50.0%

and a progressive disease (PD) rate of 20.0%. The overall response rate was 30.0%

and the disease control rate was 80.0%. According to the adopted PERCIST 1.0 criteria

the PR rate was 30.0%

the SD rate was 50.0%

and the PD rate was 20.0%.

Conclusion:

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Lu-FAP-2286 RLT demonstrated good safety and significant efficacy in patients with advanced lung cancer

with high disease control and overall response rates. Although the sample size in this study was small

the results support

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Lu-FAP-2286 RLT as a promising new strategy for treating advanced lung cancer. Further research involving larger sample sizes and longer follow-up periods is required to validate its efficacy and safety.