Experience With 177Lu-FAPI-2286 Therapy as the Last Resort in a Patient With Metastatic Colon Cancer.

A 49-year-old man diagnosed with well-differentiated adenocarcinoma of the colon, along with liver metastases, underwent several treatments, including chemotherapy, laparoscopic colostomy, and radiofrequency ablation. After receiving a liver transplant, he achieved 1-year disease-free status. However, rising serum levels of carcinoembryonic antigen (CEA) led to further evaluation, which revealed new metastases in the liver and lungs. As a last resort, he was treated with 177Lu-FAPI-2286 radioligand therapy, but the biochemical response was disappointing, as CEA levels continued to rise. Tragically, the patient experienced respiratory decompensation and passed away 10 weeks after the treatment. This case underscores the potential of FAP-targeted radioligand therapy in managing advanced colon cancer and suggests that earlier intervention might be beneficial.