SSTR2-targeted theranostics in hepatocellular carcinoma

(1) BackgroundWhile the clinical use of radiolabeled somatostatin analogs is established in neuroendocrine tumors, there is significant interest in expanding their use for other somatostatin receptor 2 (SSTR2)-expressing cancers. This study investigates the utility of SSTR2-targeted theranostics in hepatocellular carcinoma (HCC); (2) MethodsWe measured SSTR2 expression in HCC cell lines and clinical samples using qRT-PCR, Western blot, and a public dataset. We evaluated [67Gallium]Ga-DOTATATE uptake, tested [177Lutetium]Lu-DOTATATE cytotoxicity, and assessed [68Gallium]Ga-DOTATATE tumor targeting in HCC animal models and a patient via PET/CT; (3) ResultsSSTR2 expression was confirmed in HCC cell lines and clinical samples. Radioligand uptake studies validated SSTR2-mediated [67Gallium]Ga-DOTATATE uptake, and [177Lutetium]Lu-DOTATATE treatment reduced cell proliferation. [68Gallium]Ga-DOTATATE PET/CT scans detected tumors in animal models and spinal metastases in a patient with HCC; (4) ConclusionThese findings suggest for the first time that SSTR2-based theranostics could have strong implications for detection and treatment of HCC. Simple SummaryThis study investigates the use of SSTR2-targeted theranostics, combining diagnostic and therapeutic approaches, in hepatocellular carcinoma (HCC). We confirmed significant SSTR2 expression in HCC cells and patient samples, showing that radiolabeled compounds such as [67Ga]Ga-DOTATATE and [177Lu]Lu-DOTATATE, commonly used in neuroendocrine tumors, could also target HCC. In preclinical models and a patient case, PET/CT imaging and treatments demonstrated effective tumor detection and shrinkage. These findings suggest that SSTR2-targeted theranostics could offer a novel, targeted method for diagnosing and treating HCC, potentially improving outcomes for patients with this challenging cancer.