This is an open label, non-randomized trial

Each patient will undergo 2 phases of PET imaging assessments

intra-tumor accumulation of [89Zr]Zr-BI 765179

Patients with locally advanced, unresectable or metastatic solid tumors who are either refractory after standard therapy for the disease or for whom standard therapy is not appropriate

Tumor with expected high expression of Fibroblast activation protein (FAP) including the following histology: Non-small cell lung carcinoma (NSCLC)

At least 18 years of age at the time of the consent or over the legal age of consent in countries where that is greater than 18 years

Signed and dated, written informed consent (IC) in accordance with ICH-GCP and local legislation prior to admission to the trial

At least one measurable lesion outside of central nervous system (CNS) as defined per modified Response evaluation criteria in solid tumors (RECIST) 1.1

Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

Adequate liver, bone marrow and renal organ function

Male or female patients. Women of childbearing potential (WOCBP)1 and men able to father a child must be ready and able to use highly effective methods of birth control per ICH M3 (R2) that result in a low failure rate of less than 1% per year when used consistently and correctly. These methods must be used during the study and for at least 6 months after the last dose of the study medication. A list of contraception methods meeting these criteria is provided in the patient information.
Patients with brain metastases are eligible provided they meet all of the following criteria:

• brain metastases have adequately been treated and are considered stable by the Investigator
• radiotherapy or surgery for brain metastases was completed at least 2 weeks prior to the first administration of BI 765179
• patient is off steroids for at least 7 days (physiologic doses of steroids is permitted, if this was stable for the last 4 weeks)
• the patient is off anti-epileptic drugs for at least 7 days

Back-fill cohorts only:

Patient has agreed to and signed an informed consent (IC) form to provide mandatory pre-treatment and on-treatment fresh tumor biopsy

At least one lesion (separate from the evaluable target lesion outside of the CNS as defined per RECIST v1.1) that is accessible for mandatory paired pre and on-treatment biopsy

Currently enrolled in another investigational device or drug trial

Previous or concomitant malignancies other than the one treated in this trial within the last 2 years except:

• effectively treated non-melanoma skin cancers
• effectively treated carcinoma in situ of the cervix
• effectively treated ductal carcinoma in situ
• other effectively treated malignancy that is considered cured by 'local treatment'

Previous treatment with agents targeting CD137

Known leptomeningeal disease or spinal cord compression due to disease

Anticoagulant treatment that cannot be safely interrupted if medically needed (e.g., biopsy) based on the opinion of the Investigator

Persistent toxicity from previous treatments that has not resolved to ≤ Common terminology criteria for adverse events (CTCAE) Grade 1 (except for alopecia, CTCAE Grade 2 neuropathy, asthenia/fatigue or grade 2 endocrinopathies controlled by replacement therapy)

Patient has a diagnosis of immunodeficiency

Patient with history of immunosuppressive medication within 14 days prior to the first dose of BI 765179. The following are exceptions to this criterion:

• Use of intranasal, inhaled, or topical corticosteroids, local steroid injections (e.g., intra-articular injections)
• Systemic corticosteroids at physiologic doses ≤10 mg/day (prednisone or equivalent)
• Physiological replacement dose of corticosteroids