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AAA614 is an investigational radioligand therapy (RLT) developed by Novartis (through its subsidiary Advanced Accelerator Applications) for the treatment of advanced solid tumors. It consists of a small molecule peptidomimetic ligand, FAP-2286, which targets fibroblast activation protein (FAP), conjugated to the beta-emitting radioisotope lutetium-177 (177Lu). FAP is a cell-surface glycoprotein highly expressed on cancer-associated fibroblasts (CAFs) within the stroma of most epithelial tumors, including pancreatic, breast, and lung cancers, while showing limited expression in normal adult tissues. By binding to FAP, AAA614 delivers targeted ionizing radiation directly to the tumor microenvironment, causing DNA damage and subsequent cell death in both the FAP-expressing stroma and adjacent tumor cells via the 'bystander effect.' The therapy is currently in Phase 2 clinical development.
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