肉瘤包含高度多样化的恶性肿瘤，其特征在于不同的形态和分子特征。治疗难治性或晚期疾病的治疗选择是有限的。在这种背景下，治疗诊断学作为一个无缝整合诊断和治疗的创新平台应运而生，提供了广阔的前景。这份特别报告深入探讨了基于治疗​​诊断的方法在肉瘤中的初步临床应用。具体来说，它检查了针对与肉瘤相关的生物标志物的各种策略，包括成纤维细胞激活蛋白 (FAP)、前列腺特异性膜抗原 (PSMA)、C-X-C 趋化因子受体 4 型 (CXCR4) 和生长抑素受体 2 (SSTR2)。病灶中的 CXCR4 靶向放射配体及其与免疫组织化学数据的较差相关性，降低了这种治疗诊断方法在肉瘤肿瘤学环境中的吸引力。针对肉瘤的 SSTR2 靶向方法虽然可能有效，但仅限于单个病例。 FAP 抑制剂在肉瘤患者中的早期经验显示出特别有希望的结果，表明以最小的毒性有效控制疾病。虽然 PSMA 为肉瘤治疗诊断方法提供了一个诱人的目标，但其利用仍然是传闻，需要进一步研究。前瞻性和精心设计的临床试验对于描绘基于 FAPI 和 PSMA 的方法对肉瘤治疗领域的潜在影响至关重要，从而提供创新和个性化的治疗选择。

Sarcomas encompass a highly diverse range of malignancies, characterized by varied morphological and molecular profiles. Treatment options in case of therapy-refractory or advanced disease are limited. In this context, theranostics emerges as an innovative platform seamlessly integrating diagnosis and therapy, offering promising prospects.This special report delves into the initial clinical applications of theranostic-based approaches in sarcomas. Specifically, it examines various strategies targeting biomarkers associated with sarcomas, including fibroblast activation protein (FAP), prostate-specific membrane antigen (PSMA), C-X-C chemokine receptor type 4 (CXCR4) and somatostatin receptor 2 (SSTR2).The heterogeneous uptake of the CXCR4-targeted radioligand in lesions, along with its poor correlation with immunohistochemistry data, diminishes the attractiveness of this theranostic approach in the sarcoma oncological setting. SSTR2-targeted approaches in sarcoma, although potentially effective, are limited to a single case. Early experiences with FAP inhibitors in sarcoma patients have shown particularly promising outcomes, indicating effective disease control with minimal toxicity. While PSMA presents an enticing target for theranostic approaches in sarcomas, its utilization remains anecdotal and requires further investigation. Prospective and well-designed clinical trials are imperative to delineate the potential impact of FAPI- and PSMA-based approaches on sarcoma therapeutic landscapes, offering innovative and personalized treatment options.