Study of [18F]FAPI-74 PET in Patients With Gastrointestinal Cancers

Prospective, multi-center, open label, non-randomized clinical trial to assess efficacy of [18F]FAPI-74 to detect FAP expressing cells in patients diagnosed with gastrointestinal cancers, including hepatocellular carcinoma, cholangiocarcinoma, gastric, pancreatic and colorectal cancer. The [18F]FAPI-74 PET scan will be acquired in patients with proven GI cancers after initial staging using institutional standard methods. The PET scan results will be compared to FAP immunohistochemistry (as the primary objective) and histopathology (as the secondary objective) of the biopsied or resected tissues.

Inclusion Criteria:Confirmed diagnosis of gastrointestinal (GI) malignancy, including hepatocellular carcinoma, cholangiocarcinoma, gastric, pancreatic and colorectal cancerAvailable tissue sample obtained through biopsy or to be obtained through scheduled biopsy and/or surgical resectionNo treatment received between tissue sample taken and [18F]FAPI-74 PETAnatomic imaging (e.g., CT, MRI) obtained within ≤ 28 days of consentAge ≥ 18 yearsCompleted informed consent as determined per the IRB of recordExclusion Criteria:Pregnant as determined by a pregnancy test as per institutional guidelines for individuals of child-bearing potentialDeclining to use effective contraceptive methods during the study (for individuals of child-producing potential)Need for emergent surgery that would be delayed by participationBacterial, viral, or fungal infections requiring systemic therapy, that are expected to impact FAP expression in the opinion of the sponsor or their designeeSerious co-morbidities and serious nonmalignant disease (e.g., hydronephrosis, kidney failure, liver failure, systemic or local inflammatory or autoimmune diseases or other conditions) that in the opinion of the investigator, physician of record and/or Sofie could compromise subject safety and/or protocol objectivesKnown diagnosis of an autoimmune disorder that is expected to impact FAP expression in the opinion of the sponsor or their designeePatients receiving any other investigational agent within the past 28 daysBreastfeeding. Note: nursing parents are allowed if the potential participant commits to pumping breast milk and discarding it from injection to ≥ 24 hours from the time of the [18F]FAPI-74 injectionKnown hypersensitivity to any excipients used in [18F]FAPI-74: trace amounts of sodium acetate, sodium ascorbate, ascorbic acid, ethanol, acetonitrile or AlCl.Renal or liver function impairment* *Defined by liver impairments as AST>3x the upper limit of normal, ALT>3x the upper limit of normal, or bilirubin>1.5x the upper limit of normal. Renal impairment as defined by a creatinine clearance of >1.5x the upper limit of normal utilizing the Cockcroft Gault formula