When 68-year-old Maria Schneider began the experimental treatment at Curanosticum Wiesbaden-Frankfurt, she had already endured five prior therapies for her metastatic gastric cancer—each ending in progression. But after two cycles of a novel radiopharmaceutical targeting fibroblast activation protein (FAP), her tumors began to shrink. Her story is not unique. In a groundbreaking first-in-human study published in the Journal of Nuclear Medicine, FAP-targeted radiopharmaceutical therapy achieved objective responses in 66.7% of 88 patients across 21 advanced cancer types, offering new hope where options had run out.
For years, radiopharmaceutical therapies have been a lifeline for patients with neuroendocrine tumors and prostate cancer, but most solid tumors lacked a comparable targeted approach. FAP, a protein barely detectable in healthy adults, is overexpressed in the stroma of many aggressive cancers—including pancreatic, colorectal, ovarian, and sarcomas—making it a promising bullseye for precision radiation. The new therapy uses isotopes like 177Lu, 90Y, and 225Ac bound to the compound 3BP-3940 to deliver radiation directly to the tumor microenvironment.
The study, led by Dr. Richard P. Baum and Dr. Jingjing Zhang, included patients with heavily pretreated, end-stage cancers—many with fewer than six months of expected survival. Across 227 treatment cycles, the therapy was well tolerated, with mostly mild side effects. Tumor responses were striking: 3.0% achieved complete remission, 51.5% had partial remission, and 15.2% saw stable disease. That translates to disease control in over 80% of patients—an exceptional outcome in such a frail population. The median overall survival was seven months from treatment initiation, a meaningful extension for individuals who had exhausted all standard therapies.
"Even in this challenging group, we observed tumor shrinkage or disease stabilization in many cases," said Dr. Baum. "For patients who have run out of options, this kind of therapy can make a meaningful difference, not only in controlling the disease but also in maintaining quality of life."
What excites researchers most is the therapy’s breadth. "We're no longer limited to treating just one cancer type," said Dr. Zhang. "By targeting the tumor microenvironment itself, we're seeing meaningful responses across many cancers, even in patients with few remaining options." This approach could pave the way for a new class of pan-cancer radiopharmaceuticals, transforming how we treat advanced solid tumors.
While larger trials are needed, the results mark a turning point—offering not just longer survival, but renewed hope for patients once told there was nothing more to be done.