CTR-FAPI PET enables precision management of medullary thyroid carcinoma.

IF 29.7 1区医学 Q1 ONCOLOGY

Cancer discovery Pub Date : 2024-10-29 DOI:10.1158/2159-8290.CD-24-0897

Ziren Kong, Zhu Li, Xi-Yang Cui, Jian Wang, Mengxin Xu, Yang Liu, Junyi Chen, Song Ni, Zongmin Zhang, Xiaowei Fan, Jiazhao Huang, Yansong Lin, Yuning Sun, Yuqin He, Xinfeng Lin, Tianyu Meng, Han Li, Yixuan Song, Boshizhang Peng, Changming An, Chenyan Gao, Nan Li, Chen Liu, Yiming Zhu, Zhi Yang, Zhibo Liu, Shaoyan Liu

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引用次数: 0

Abstract

Medullary thyroid carcinoma (MTC) can only be cured through the excision of all metastatic lesions, but 29-60% patients failed to localize the disease in the current clinical practice. Previously, we developed a fibroblast activation protein inhibitor (FAPI)-based covalent targeted radioligand (CTR) for improved detection sensitivity and accuracy. In this first-in-class clinical trial, we head-to-head compared [68Ga]Ga-CTR-FAPI PET-CT and [18F]FDG PET-CT in 50 MTC patients. The primary endpoint was the patient-based detection rate, with [68Ga]Ga-CTR-FAPI exhibiting higher detection than [18F]FDG (98% vs. 66%, p=0.0002). This improved detection was attributed to increased tumor uptake (SUVmax 11.71±9.16 vs. 2.55±1.73, p<0.0001). Diagnostic accuracy, validated on lesions with gold-standard pathology, was greater for [68Ga]Ga-CTR-FAPI compared to [18F]FDG (96.7% vs. 43.3%, p<0.0001). Notably, 32% patients altered management following [68Ga]Ga-CTR-FAPI PET-CT, and 66.7% patients changed their surgical plan. Overall, [68Ga]Ga-CTR-FAPI PET-CT provided superior detection and diagnostic accuracy compared to [18F]FDG PET-CT, enabling precision management of MTC patients.

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CTR-FAPI PET 实现了甲状腺髓样癌的精准治疗。

甲状腺髓样癌（MTC）只有通过切除所有转移灶才能治愈，但在目前的临床实践中，有29%-60%的患者无法对疾病进行定位。此前，我们开发了一种基于成纤维细胞活化蛋白抑制剂（FAPI）的共价靶向放射性配体（CTR），以提高检测灵敏度和准确性。在这项首创的临床试验中，我们对 50 名 MTC 患者进行了[68Ga]Ga-CTR-FAPI PET-CT 和[18F]FDG PET-CT 的头对头比较。主要终点是基于患者的检出率，[68Ga]Ga-CTR-FAPI的检出率高于[18F]FDG（98% 对 66%，P=0.0002）。检测率的提高归因于肿瘤摄取量的增加（SUVmax 11.71±9.16 vs. 2.55±1.73，p

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来源期刊

Cancer discovery ONCOLOGY-

CiteScore

22.90

自引率

1.40%

发文量

838

审稿时长

6-12 weeks

期刊介绍： Cancer Discovery publishes high-impact, peer-reviewed articles detailing significant advances in both research and clinical trials. Serving as a premier cancer information resource, the journal also features Review Articles, Perspectives, Commentaries, News stories, and Research Watch summaries to keep readers abreast of the latest findings in the field. Covering a wide range of topics, from laboratory research to clinical trials and epidemiologic studies, Cancer Discovery spans the entire spectrum of cancer research and medicine.