Key result
High FAP-α expression linked to ~49% worse overall survival in cancer patients.
Why the study?
High expression of FAP-alpha is associated with distant metastasis, but its role in predicting overall survival in cancer patients needed systematic evaluation.
Does FAP-α overexpression predict poor overall survival in cancer patients?
Meta-Analysis
Does FAP-α overexpression predict poor overall survival in cancer patients?
Hazard Ratio: 1.49 (95% CI 1.19–1.85)
p-value: p=<0.001
FAP-α overexpression is significantly associated with poor overall survival in cancer patients, suggesting its potential utility as a prognostic biomarker to identify high-risk patients.
High FAP-α expression may indicate poorer cancer prognosis; leaves open whether it is a viable therapeutic target.
INTRODUCTION: Fibroblast activation protein-alpha (FAP-α) is a vital surface marker of cancer-associated fibroblasts, and its high expression is associated with distant metastasis. This systematic review and meta-analysis were performed to predict the role of FAP-α overexpression in the overall survival rate of cancer patients. METHODS: This systematic review and meta-analysis were first performed on studies published in online databases, including PubMed, Scopus, and Web of Sciences, based on the PRISMA framework. We focused on all cancer patients with reported FAP-α expression levels and survival rate outcomes. Two reviewers independently conducted study selection and data extraction, and discrepancies were resolved through group discussion. Pooled hazard ratios (HRs) were then calculated by the fixed-effect and random-effects models to determine the association between FAP-α with crude HR (univariable), adjusted HR (multivariable), progression-free survival, and disease-free survival. RESULTS: Forty-one studies were included in the systematic review, and 25 were included in the meta-analysis. Meta-analysis showed that high FAP-α expression was associated with the pooled HR for overall survival (HR = 1.49, 95% CI: 1.19-1.85, P < 0.001) and HR of 1.53 in studies that reported the adjusted effect of high FAP-α expression on overall survival (HR = 1.53, 95% CI: 1.16-2.03, P = 0.003), and HR of 1.36 for disease-free survival (HR = 1.36, 95% CI: 0.750-2.469, P = 0.31). In addition, lymph node metastasis and distant metastasis were significant factors and had pooled HRs of 2.053 (95% CI: 1.603-2.630, P < 0.001) and 2.630 (95% CI: 1.902-3.637, P < 0.001), respectively. CONCLUSIONS: Our results showed that cancer patients with FAP-α overexpression had a significant association with poor overall survival. Incorporating FAP-α testing into cancer diagnostic protocols can help identify high-risk patients requiring more critical treatment interventions.
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Janani et al. (2025) conducted a meta-analysis in Cancer. High FAP-α expression vs. Low or negative FAP-α expression was evaluated on Overall survival (HR 1.49, 95% CI 1.19-1.85, p=<0.001). High FAP-α expression was significantly associated with poorer overall survival in cancer patients (HR 1.49).
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