Combined 177Lu-FAP-2286 Therapy and Chemotherapy in Extraskeletal Ewing Sarcoma With Multiple Metastases.

A 23-year-old man with metastatic extraskeletal Ewing sarcoma, who was unable to tolerate standard-dose chemotherapy, received 1 cycle of 177Lu-FAP-2286, followed by 2 cycles of reduced-dose ifosfamide/epirubicin/mesna chemotherapy. Follow-up 68Ga-FAP-2286 PET/CT at 2 months showed a marked metabolic response with reduced tumor size and tracer uptake. No adverse events were observed. The patient remained symptom-free at 2 months. This case suggests that 177Lu-FAP-2286 combined with chemotherapy may have clinical utility in advanced Ewing sarcoma.