# FAPI PET

Source: https://onco.cc/technologies/fapi-pet/  
OnCo record `fapi-pet` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

FAPI PET is a PET scan that lights up the scaffolding around almost any solid tumour, including cancers the standard sugar scan misses.

## Summary

Quinoline-based FAP inhibitors (FAPI-04, FAPI-46, FAPI-74) labelled with 68Ga or 18F image cancer-associated fibroblasts. Superior to FDG in pancreatic, gastric, HCC, and peritoneal disease in head-to-head series. Registrational trials for 68Ga-FAPI-46 and 18F-FAPI-74 (Sofie) are underway. Pairs with FAP-targeted radioligands.

## Fields

- Kind: Technology
- Status: phase-3
- Last checked: 2026-09-04
- Principle: Small molecule binds FAP on stromal fibroblasts; rapid uptake, low background, minimal brain and liver signal.
- Since: 2018
- Strengths: Pan-cancer, high contrast; No fasting needed; Sees desmoplastic tumours FDG misses
- Limitations: Also uptake in fibrosis, healing, arthritis; Reports stroma not tumour cells; Not yet approved

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Fibroblast_activation_protein,_alpha
- Wikipedia: https://en.wikipedia.org/wiki/Fibroblast_activation_protein,_alpha

## Connected records

- cancers: [Biliary tract cancer (cholangiocarcinoma)](https://onco.cc/cancers/cholangiocarcinoma/), [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [Locally advanced unresectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/locally-advanced-pdac/), [Mesothelioma](https://onco.cc/cancers/mesothelioma/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- fronts: [Imaging](https://onco.cc/fronts/imaging/)
- technologies: [CAR-T against stroma: fibroblasts and myeloid cells](https://onco.cc/technologies/stroma-directed-car/), [FES PET (oestrogen receptor imaging)](https://onco.cc/technologies/fes-pet/), [PET (positron emission tomography)](https://onco.cc/technologies/pet/)
- targets: [FAP](https://onco.cc/targets/fap/)
- terms: [Cancer-associated fibroblasts (CAFs)](https://onco.cc/terms/cancer-associated-fibroblasts/), [Desmoplasia (tumour stroma)](https://onco.cc/terms/desmoplasia/)
- ideas: [A 28-day national pathway for people with a positive multi-cancer blood test](https://onco.cc/ideas/idea-prev-mced-positive-resolution-pathway/), [A university cyclotron network with shared regulatory files for new tracers](https://onco.cc/ideas/idea-fund-academic-radiopharma-pipeline/), [FAP theranostics as a pan-cancer stromal strategy](https://onco.cc/ideas/idea-fap-theranostics-pancancer/), [FAPI PET as the workup for MCED positives](https://onco.cc/ideas/idea-mced-plus-fapi/), [Reprogramme the stroma rather than remove it: second-generation stromal trials with a stromal biomarker and a survival endpoint](https://onco.cc/ideas/idea-pdac-stromal-reprogramming-not-depletion/), [What actually holds T cells at the tumour border?](https://onco.cc/ideas/idea-immune-exclusion-drivers/), [When the blood test is positive, hunt for the lesion with sensitive imaging](https://onco.cc/ideas/idea-bio2-localise-the-mrd/)
- drugs: [FAP-2286 (177Lu / 68Ga)](https://onco.cc/drugs/fap-2286/)
- companies: [SOFIE Biosciences](https://onco.cc/companies/sofie-biosciences/)
- institutions: [All India Institute of Medical Sciences, New Delhi](https://onco.cc/institutions/aiims-delhi/), [Curanosticum Wiesbaden-Frankfurt](https://onco.cc/institutions/curanosticum/), [European Association of Nuclear Medicine](https://onco.cc/institutions/eanm/), [Heidelberg University Hospital / NCT / DKFZ](https://onco.cc/institutions/heidelberg-nct/), [Postgraduate Institute of Medical Education and Research, Chandigarh](https://onco.cc/institutions/pgimer-chandigarh/), [TUM Klinikum rechts der Isar / CCC München](https://onco.cc/institutions/tum-munich/), [University Hospital Düsseldorf / CIO Düsseldorf](https://onco.cc/institutions/uk-duesseldorf/)
- roadmaps: [Molecular imaging roadmap: FDG → PSMA → FAP → antigen and immune PET](https://onco.cc/roadmaps/molecular-imaging-roadmap/), [Radiopharmaceutical roadmap: iodine → lutetium → actinium](https://onco.cc/roadmaps/radiopharma-roadmap/)
- people: [Frederik Giesel](https://onco.cc/people/frederik-giesel/), [Ken Herrmann](https://onco.cc/people/ken-herrmann/), [Shaoli Song](https://onco.cc/people/song-shaoli/), [Uwe Haberkorn](https://onco.cc/people/uwe-haberkorn/), [Wolfgang A. Weber](https://onco.cc/people/wolfgang-weber/)
- pathways: [Fibroblast activation, desmoplasia & matrix stiffness](https://onco.cc/pathways/caf-activation-desmoplasia/), [Invasion: proteases, adhesion & the invasive front](https://onco.cc/pathways/invasion-ecm-degradation/), [Tumour microenvironment (TME)](https://onco.cc/pathways/tumor-microenvironment/)
- trials: [A Study of 177Lu-FAP-2286 in Advanced Solid Tumors](https://onco.cc/trials/nct04939610/), [An Open-label Study Comparing Lutetium (177Lu) Vipivotide Tetraxetan Versus Observation in PSMA Positive OMPC.](https://onco.cc/trials/nct05939414/), [Anti-tumour Activity of (177Lu) rhPSMA-10.1 Injection](https://onco.cc/trials/nct05413850/), [Study to Evaluate the Diagnostic Performance of GEH300079 (68Ga) Injection PET/CT for Detection of PC in Patients With Colorectal, Gastric, Ovarian, o](https://onco.cc/trials/nct07219238/)

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