Targeting the Untargetable: [ ¹⁶¹ Tb]Tb-FAP-2286 in Young-Onset Refractory Cholangiocarcinoma

Paediatric and adolescent cholangiocarcinoma (CCC) is extremely rare, and an advanced-stage diagnosis precludes surgical intervention as a primary treatment. Therefore, early diagnosis and precise staging are critical for improving patient outcomes. A pronounced desmoplastic reaction is the hallmark of cholangiocarcinoma, positioning FAPI as a promising theragnostic approach for patients unresponsive to conventional therapies. We present a case of young-onset refractory cholangiocarcinoma, refractory to multiple treatment lines, administered [ 161 Tb]Tb-FAP-2286, exhibiting a partial response.