Comprehensive Characterization via Molecular Imaging, Longitudinal Multisite Sampling, and Autoptic Work-up in Advanced Small Cell Lung Cancer Undergoing SSTR-Directed Radiopharmaceutical Therapy

• DOI: 10.2967/jnumed.124.268513
• Publication Date: 2025-01-16T22:00:21Z
• Authors: Johanna S. Enke; Nic G. Reitsam; Sebastian Dintner; Friederike Liesch...; Tina Schaller; Josua A. Decker; Angela Langer; Eva Sipos; Ana Antic Nikolic; Thomas Kröncke; Martin Trepel; Constantin Lapa; Rainer Claus; Bruno Märkl; Ralph A. Bundschuh
• Keywords: Molecular Imaging

Despite the addition of immune checkpoint blockade to first-line chemotherapy, prognosis for patients with small cell lung cancer (SCLC) is still devastating. For subset SCLC somatostatin receptor (SSTR) overexpression, radiopharmaceutical therapy (RPT) might be an effective future treatment option. <b>Methods:</b> Here, we present case a heavily pretreated stage IV patient showing exceptional response SSTR-directed RPT. A comprehensive translational work-up consisting histopathologic, immunohistochemical, and molecular pathology analyses at different time points during especially lesions discordant tracer uptake was performed. <b>Results:</b> Besides promising RPT, interesting signs clonal dynamics under and, most importantly, SSTR downregulation some as potential evasion mechanism RPT could identified. <b>Conclusion:</b> This unique investigation clinical–molecular understanding novel paradigms in may provide basis designs.