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Title: Exploring the Potential of FAPI Therapy as a Promising Intervention for Hepatocellular Carcinoma with Portal Vein Thrombosis: A Future Outlook
e-poster Number: EPOS 50
Category: e Poster
Author Name: Dr. Sunay G Duragappanavar
Institute:
Co-Author Name:
Abstract :
CLINICAL HISTORY/OBJECTIVE
• 62 Yr old male gentleman presented with Loss of appetite and weight loss since 1 year
• Evaluated with 68Ga-FAPI PET CT abdomen – cirrhosis, mass lesions in segment VII & VIII of Liver with portal vein thrombosis.
• S.AFP: 223 ng/dL, TBC- 1.9mg/dL, GGT-104U/L
• HPE – Hepatocellular carcinoma
RESULTS
• In view of HCC with portal vein thrombosis, Intra arterial 177Lutetium-FAPI(Fibroblast activation protein inhibitor) targeted therapy was done on 31.01.2023 as per institutional protocol.
• 1st follow up CECT Abdomen (01.03.2023)
o Reduction in size of lesion
o Resolution of main and left portal vein thrombus
• In view of raised serum AFP (1190 IU/dL) Trans Arterial Chemoembolization (TACE) with Lipiodol done on 24.04.2023
• 2nd follow up CECT Abdomen (01.06.2023)
o No obvious residual / recurrent disease
o Chronic thrombosis of the anterior division of right portal vein
DISCUSSIONS
• FAP is a unique transmembrane glycoprotein exclusively expressed by Cancer associated fibroblasts (CAF). This FAP provides a reliable target for artificially produced ligands (FAP-inhibitors) which are tagged with radioisotopes.
• Hence highly effective and tumor specific treatment can be delivered, especially in the advanced and terminal stage patients improving survival and quality of life with high patient compliance and good safety profile.
• Additionally, its ability to target even the metastatic lesions make it superior to the available locoregional therapies, emerging as an effective alternative or replacement to current loco-regional therapies.
CONLUSIONS:
• FAPI therapy is novel anticancer therapy for FAP avid cancers
• It is emerging as an effective alternative or replacement to current loco-regional therapies.
