The emerging role of [68Ga]Ga-Pentixafor PET/CT in precision staging and targeted therapy guidance for small cell lung cancer management

Small cell lung cancer (SCLC) remains a highly aggressive malignancy with poor prognosis, underscoring the urgent need for improved diagnostic and therapeutic strategies. [ 68 Ga]Ga-Pentixafor PET/CT, a novel molecular imaging modality targeting the CXCR4 receptor, offers precise in vivo localization and quantification of CXCR4 expression, which is notably elevated in SCLC. This review summarizes current advances in the application of [ 68 Ga]Ga-Pentixafor PET/CT for SCLC, focusing on its role in accurate disease staging, differentiation of pathological subtypes, and guidance of targeted therapies. By integrating quantitative data from immunohistochemistry and flow cytometry, this imaging technique may provide complementary molecular information for lesion characterization and patient stratification. Despite promising results, challenges such as standardization of imaging protocols and validation in larger clinical cohorts remain. Through a comprehensive analysis of existing literature, this article aims to provide theoretical foundations and clinical insights to clarify its potential role and current limitations as a CXCR4-targeted molecular imaging tool for SCLC. Overall, [ 68 Ga]Ga-Pentixafor PET/CT shows potential as a CXCR4-targeted imaging biomarker in SCLC, but further large-scale validation is required before routine clinical implementation.