NCT06916338

Clinical Study of 18F-Labeled FAPI-04 in PET Imaging of Breast Cancer

• Status: Recruiting
• Phase: —
• Study type: Observational
• Enrollment: 30 (estimated)
• Sponsor: The Affiliated Hospital of Qingdao University · Academic / Other
• Sex: All
• Age: 18 Years – 75 Years
• Healthy volunteers: Not accepted

Summary

This study aims to evaluate the diagnostic accuracy (sensitivity, specificity, positive/negative predictive value, and overall accuracy) of 18F-FAPI-04 PET imaging in breast cancer for detecting fibroblast activation protein (FAP)-rich lesions. Additionally, the study will longitudinally monitor dynamic changes in FAP expression levels and tumor size during therapy, including chemotherapy, targeted therapy, or immunotherapy.The non-invasive nature of 18F-FAPI-04 PET addresses limitations of traditional biopsy-dependent stromal evaluation, offering whole-body quantification of tumor microenvironment dynamics to optimize therapeutic decision-making.

Detailed description

Breast cancer diagnosis and treatment continue to face challenges in adequately assessing tumor heterogeneity and dynamically monitoring therapeutic responses. Traditional biopsy-dependent pathological analysis is limited by its invasive nature, sampling bias, and inability to repeatedly sample tissues, making it difficult to capture the spatiotemporal heterogeneity of cancer-associated fibroblasts (CAFs) within the systemic tumor microenvironment (TME). Fibroblast activation protein (FAP), a core marker of CAFs, plays a critical role in tumor proliferation, metastasis, immune evasion, and drug resistance, with its expression levels significantly correlating with patient prognosis. However, current imaging techniques, such as 18F-FDG PET, primarily reflect tumor metabolic activity and lack sufficient sensitivity for detecting FAP-positive lesions with low metabolism but high aggressiveness. They also fail to differentiate post-therapy inflammatory responses from residual tumor activity. 18F-FAPI-04 PET overcomes these biological limitations of conventional imaging by precisely targeting FAP, enabling non-invasive molecular visualization of systemic lesions. Its high target-to-background ratio allows detection of early-stage micrometastases (e.g., lymph node or bone metastases), addressing the risk of missed diagnoses with FDG PET. Furthermore, by quantifying dynamic changes in FAP expression, it enables real-time monitoring of therapy-induced stromal remodeling (e.g., CAF depletion post-immunotherapy or pro-fibrotic responses post-chemotherapy), providing critical insights into resistance mechanisms and treatment efficacy prediction. This study aims to evaluate the diagnostic performance (sensitivity, specificity, predictive values, accuracy) of 18F-FAPI-04 PET imaging in breast cancer. Additionally, it will monitor dynamic changes in FAP expression and tumor size during therapy, providing insights for patient stratification, clinical staging, treatment response assessment, early detection of resistance, and recurrence/metastasis, ultimately guiding personalized therapeutic strategies.

Conditions

• Breast Cancer

Interventions

Type	Name	Description
RADIATION	18F-FAPI-04 PET scan	FAPI-04, labeled with PET radio-nuclide 18F will be used as a molecular imaging tracer for PET scan. All participants will undergo 18F-FAPI-04 PET scan.

Timeline

• Start date: 2025-04-11
• Primary completion: 2026-12-01
• Completion: 2027-12-01
• First posted: 2025-04-08
• Last updated: 2025-04-29

Locations

1 site across 1 country: China