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Halford S, Veal GJ, Wedge SR, Payne GS, Bacon CM, Sloan P, Dragoni I, Heinzmann K, Potter S, Salisbury BM, Chenard-Poirier M, Greystoke A, Howell EC, Innes WA, Morris K, Plummer C, Rata M, Petrides G, Keun HC, Banerji U, Plummer R. A Phase I Dose-escalation Study of AZD3965, an Oral Monocarboxylate Transporter 1 Inhibitor, in Patients with Advanced Cancer. Clin Cancer Res 2023; 29:1429-1439. [PMID: 36652553 PMCID: PMC7614436 DOI: 10.1158/1078-0432.ccr-22-2263] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/20/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE Inhibition of monocarboxylate transporter (MCT) 1-mediated lactate transport may have cytostatic and/or cytotoxic effects on tumor cells. We report results from the dose-escalation part of a first-in-human trial of AZD3965, a first-in-class MCT1 inhibitor, in advanced cancer. PATIENTS AND METHODS This multicentre, phase I, dose-escalation and dose-expansion trial enrolled patients with advanced solid tumors or lymphoma and no standard therapy options. Exclusion criteria included history of retinal and/or cardiac disease, due to MCT1 expression in the eye and heart. Patients received daily oral AZD3965 according to a 3+3 then rolling six design. Primary objectives were to assess safety and determine the MTD and/or recommended phase II dose (RP2D). Secondary objectives for dose escalation included measurement of pharmacokinetic and pharmacodynamic activity. Exploratory biomarkers included tumor expression of MCT1 and MCT4, functional imaging of biological impact, and metabolomics. RESULTS During dose escalation, 40 patients received AZD3965 at 5-30 mg once daily or 10 or 15 mg twice daily. Treatment-emergent adverse events were primarily grade 1 and/or 2, most commonly electroretinogram changes (retinopathy), fatigue, anorexia, and constipation. Seven patients receiving ≥20 mg daily experienced dose-limiting toxicities (DLT): grade 3 cardiac troponin rise (n = 1), asymptomatic ocular DLTs (n = 5), and grade 3 acidosis (n = 1). Plasma pharmacokinetics demonstrated attainment of target concentrations; pharmacodynamic measurements indicated on-target activity. CONCLUSIONS AZD3965 is tolerated at doses that produce target engagement. DLTs were on-target and primarily dose-dependent, asymptomatic, reversible ocular changes. An RP2D of 10 mg twice daily was established for use in dose expansion in cancers that generally express high MCT1/low MCT4).
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Affiliation(s)
- Sarah Halford
- Cancer Research UK Centre for Drug Development, London, United Kingdom
| | - Gareth J Veal
- Newcastle University Centre for Cancer, Newcastle upon Tyne, United Kingdom
| | - Stephen R Wedge
- Newcastle University Centre for Cancer, Newcastle upon Tyne, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Geoffrey S Payne
- Cancer Research UK Imaging Centre, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Chris M Bacon
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Philip Sloan
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Ilaria Dragoni
- Cancer Research UK Centre for Drug Development, London, United Kingdom
| | - Kathrin Heinzmann
- Cancer Research UK Centre for Drug Development, London, United Kingdom
| | - Sarah Potter
- Cancer Research UK Centre for Drug Development, London, United Kingdom
| | - Becky M Salisbury
- Cancer Research UK Centre for Drug Development, London, United Kingdom
| | - Maxime Chenard-Poirier
- The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Alastair Greystoke
- Newcastle University Centre for Cancer, Newcastle upon Tyne, United Kingdom
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Elizabeth C Howell
- Newcastle University Centre for In Vivo Imaging, Newcastle, United Kingdom
| | - William A Innes
- Newcastle University, Newcastle upon Tyne, United Kingdom
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Type, United Kingdom
| | - Karen Morris
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, Manchester, United Kingdom
| | - Chris Plummer
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Mihaela Rata
- The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | | | | | - Udai Banerji
- The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Ruth Plummer
- Newcastle University Centre for Cancer, Newcastle upon Tyne, United Kingdom
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
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Thomas C, Delfour‐Peyrethon R, Lambert K, Granata C, Hobbs T, Hanon C, Bishop DJ. The effect of pre-exercise alkalosis on lactate/pH regulation and mitochondrial respiration following sprint-interval exercise in humans. Front Physiol 2023; 14:1073407. [PMID: 36776968 PMCID: PMC9911540 DOI: 10.3389/fphys.2023.1073407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
Purpose: The purpose of this study was to evaluate the effect of pre-exercise alkalosis, induced via ingestion of sodium bicarbonate, on changes to lactate/pH regulatory proteins and mitochondrial function induced by a sprint-interval exercise session in humans. Methods: On two occasions separated by 1 week, eight active men performed a 3 × 30-s all-out cycling test, interspersed with 20 min of recovery, following either placebo (PLA) or sodium bicarbonate (BIC) ingestion. Results: Blood bicarbonate and pH were elevated at all time points after ingestion in BIC vs PLA (p < 0.05). The protein content of monocarboxylate transporter 1 (MCT1) and basigin (CD147), at 6 h and 24 h post-exercise, and sodium/hydrogen exchanger 1 (NHE1) 24 h post-exercise, were significantly greater in BIC compared to PLA (p < 0.05), whereas monocarboxylate transporter 4 (MCT4), sodium/bicarbonate cotransporter (NBC), and carbonic anhydrase isoform II (CAII) content was unchanged. These increases in protein content in BIC vs. PLA after acute sprint-interval exercise may be associated with altered physiological responses to exercise, such as the higher blood pH and bicarbonate concentration values, and lower exercise-induced oxidative stress observed during recovery (p < 0.05). Additionally, mitochondrial respiration decreased after 24 h of recovery in the BIC condition only, with no changes in oxidative protein content in either condition. Conclusion: These data demonstrate that metabolic alkalosis induces post-exercise increases in several lactate/pH regulatory proteins, and reveal an unexpected role for acidosis in mitigating the loss of mitochondrial respiration caused by exercise in the short term.
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Affiliation(s)
- Claire Thomas
- LBEPS, Univ Evry, IRBA, University Paris Saclay, Evry, France,French Institute of Sport (INSEP), Research Department, Laboratory Sport, Expertise, and Performance, Paris, France,*Correspondence: Claire Thomas,
| | - Rémi Delfour‐Peyrethon
- French Institute of Sport (INSEP), Research Department, Laboratory Sport, Expertise, and Performance, Paris, France,Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia
| | - Karen Lambert
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Cesare Granata
- French Institute of Sport (INSEP), Research Department, Laboratory Sport, Expertise, and Performance, Paris, France,Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia,Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany,German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Thomas Hobbs
- LBEPS, Univ Evry, IRBA, University Paris Saclay, Evry, France
| | - Christine Hanon
- French Institute of Sport (INSEP), Research Department, Laboratory Sport, Expertise, and Performance, Paris, France,French Athletics Federation, Paris, France
| | - David J. Bishop
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia
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Beloueche-Babari M, Wantuch S, Casals Galobart T, Koniordou M, Parkes HG, Arunan V, Chung YL, Eykyn TR, Smith PD, Leach MO. MCT1 Inhibitor AZD3965 Increases Mitochondrial Metabolism, Facilitating Combination Therapy and Noninvasive Magnetic Resonance Spectroscopy. Cancer Res 2017; 77:5913-5924. [PMID: 28923861 PMCID: PMC5669455 DOI: 10.1158/0008-5472.can-16-2686] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 06/01/2017] [Accepted: 09/06/2017] [Indexed: 12/31/2022]
Abstract
Monocarboxylate transporters (MCT) modulate tumor cell metabolism and offer promising therapeutic targets for cancer treatment. Understanding the impact of MCT blockade on tumor cell metabolism may help develop combination strategies or identify pharmacodynamic biomarkers to support the clinical development of MCT inhibitors now in clinical trials. In this study, we assessed the impact of the MCT1 inhibitor AZD3965 on cancer cell metabolism in vitro and in vivo Exposing human lymphoma and colon carcinoma cells to AZD3965 increased MCT4-dependent accumulation of intracellular lactate, inhibiting monocarboxylate influx and efflux. AZD3965 also increased the levels of TCA cycle-related metabolites and 13C-glucose mitochondrial metabolism, enhancing oxidative pyruvate dehydrogenase and anaplerotic pyruvate carboxylase fluxes. Increased mitochondrial metabolism was necessary to maintain cell survival under drug stress. These effects were counteracted by coadministration of the mitochondrial complex I inhibitor metformin and the mitochondrial pyruvate carrier inhibitor UK5099. Improved bioenergetics were confirmed in vivo after dosing with AZD3965 in mouse xenograft models of human lymphoma. Our results reveal new metabolic consequences of MCT1 inhibition that might be exploited for therapeutic and pharmacodynamic purposes. Cancer Res; 77(21); 5913-24. ©2017 AACR.
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Affiliation(s)
- Mounia Beloueche-Babari
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, London, United Kingdom.
| | - Slawomir Wantuch
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Teresa Casals Galobart
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Markella Koniordou
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Harold G Parkes
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Vaitha Arunan
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Yuen-Li Chung
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Thomas R Eykyn
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Paul D Smith
- AstraZeneca, Cancer Biosciences, Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - Martin O Leach
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, London, United Kingdom
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Kershaw S, Cummings J, Morris K, Tugwood J, Dive C. Optimisation of immunofluorescence methods to determine MCT1 and MCT4 expression in circulating tumour cells. BMC Cancer 2015; 15:387. [PMID: 25957999 PMCID: PMC4436118 DOI: 10.1186/s12885-015-1382-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/28/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The monocarboxylate transporter-1 (MCT1) represents a novel target in rational anticancer drug design while AZD3965 was developed as an inhibitor of this transporter and is undergoing Phase I clinical trials ( http://www.clinicaltrials.gov/show/NCT01791595 ). We describe the optimisation of an immunofluorescence (IF) method for determination of MCT1 and MCT4 in circulating tumour cells (CTC) as potential prognostic and predictive biomarkers of AZD3965 in cancer patients. METHODS Antibody selectivity was investigated by western blotting (WB) in K562 and MDAMB231 cell lines acting as positive controls for MCT1 and MCT4 respectively and by flow cytometry also employing the control cell lines. Ability to detect MCT1 and MCT4 in CTC as a 4(th) channel marker utilising the Veridex™ CellSearch system was conducted in both human volunteer blood spiked with control cells and in samples collected from small cell lung cancer (SCLC) patients. RESULTS Experimental conditions were established which yielded a 10-fold dynamic range (DR) for detection of MCT1 over MCT4 (antibody concentration 6.25 μg/mL; integration time 0.4 seconds) and a 5-fold DR of MCT4 over MCT 1 (8 μg/100 μL and 0.8 seconds). The IF method was sufficiently sensitive to detect both MCT1 and MCT4 in CTCs harvested from cancer patients. CONCLUSIONS The first IF method has been developed and optimised for detection of MCT 1 and MCT4 in cancer patient CTC.
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Affiliation(s)
- Stephen Kershaw
- Clinical and Experimental Pharmacology Group, Manchester Cancer Research Centre, Cancer Research UK Manchester Institute, University of Manchester, Manchester, M20 4BX, UK.
| | - Jeffrey Cummings
- Clinical and Experimental Pharmacology Group, Manchester Cancer Research Centre, Cancer Research UK Manchester Institute, University of Manchester, Manchester, M20 4BX, UK.
| | - Karen Morris
- Clinical and Experimental Pharmacology Group, Manchester Cancer Research Centre, Cancer Research UK Manchester Institute, University of Manchester, Manchester, M20 4BX, UK.
| | - Jonathan Tugwood
- Clinical and Experimental Pharmacology Group, Manchester Cancer Research Centre, Cancer Research UK Manchester Institute, University of Manchester, Manchester, M20 4BX, UK.
| | - Caroline Dive
- Clinical and Experimental Pharmacology Group, Manchester Cancer Research Centre, Cancer Research UK Manchester Institute, University of Manchester, Manchester, M20 4BX, UK.
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Bola BM, Chadwick AL, Michopoulos F, Blount KG, Telfer BA, Williams KJ, Smith PD, Critchlow SE, Stratford IJ. Inhibition of monocarboxylate transporter-1 ( MCT1) by AZD3965 enhances radiosensitivity by reducing lactate transport. Mol Cancer Ther 2014; 13:2805-16. [PMID: 25281618 PMCID: PMC4258406 DOI: 10.1158/1535-7163.mct-13-1091] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Inhibition of the monocarboxylate transporter MCT1 by AZD3965 results in an increase in glycolysis in human tumor cell lines and xenografts. This is indicated by changes in the levels of specific glycolytic metabolites and in changes in glycolytic enzyme kinetics. These drug-induced metabolic changes translate into an inhibition of tumor growth in vivo. Thus, we combined AZD3965 with fractionated radiation to treat small cell lung cancer (SCLC) xenografts and showed that the combination provided a significantly greater therapeutic effect than the use of either modality alone. These results strongly support the notion of combining MCT1 inhibition with radiotherapy in the treatment of SCLC and other solid tumors.
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Affiliation(s)
- Becky M Bola
- Manchester Pharmacy School, Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom. Clinical and Experimental Pharmacology, CR-UK Manchester Institute, Manchester, United Kingdom
| | - Amy L Chadwick
- Manchester Pharmacy School, Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom. Breakthrough Breast Cancer, Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Kathryn G Blount
- Manchester Pharmacy School, Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
| | - Brian A Telfer
- Manchester Pharmacy School, Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
| | - Kaye J Williams
- Manchester Pharmacy School, Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
| | - Paul D Smith
- Oncology iMED, AstraZeneca, Mereside, Cheshire, United Kingdom
| | | | - Ian J Stratford
- Manchester Pharmacy School, Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom.
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Leroy C, Pierre K, Simpson IA, Pellerin L, Vannucci SJ, Nehlig A. Temporal changes in mRNA expression of the brain nutrient transporters in the lithium-pilocarpine model of epilepsy in the immature and adult rat. Neurobiol Dis 2011; 43:588-97. [PMID: 21624469 PMCID: PMC3726264 DOI: 10.1016/j.nbd.2011.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Revised: 05/09/2011] [Accepted: 05/14/2011] [Indexed: 11/30/2022] Open
Abstract
The lithium-pilocarpine model mimics most features of human temporal lobe epilepsy. Following our prior studies of cerebral metabolic changes, here we explored the expression of transporters for glucose (GLUT1 and GLUT3) and monocarboxylates (MCT1 and MCT2) during and after status epilepticus (SE) induced by lithium-pilocarpine in PN10, PN21, and adult rats. In situ hybridization was used to study the expression of transporter mRNAs during the acute phase (1, 4, 12 and 24h of SE), the latent phase, and the early and late chronic phases. During SE, GLUT1 expression was increased throughout the brain between 1 and 12h of SE, more strongly in adult rats; GLUT3 increased only transiently, at 1 and 4h of SE and mainly in PN10 rats; MCT1 was increased at all ages but 5-10-fold more in adult than in immature rats; MCT2 expression increased mainly in adult rats. At all ages, MCT1 and MCT2 up-regulation was limited to the circuit of seizures while GLUT1 and GLUT3 changes were more widespread. During the latent and chronic phases, the expression of nutrient transporters was normal in PN10 rats. In PN21 rats, GLUT1 was up-regulated in all brain regions. In contrast, in adult rats GLUT1 expression was down-regulated in the piriform cortex, hilus and CA1 as a result of extensive neuronal death. The changes in nutrient transporter expression reported here further support previous findings in other experimental models demonstrating rapid transcriptional responses to marked changes in cerebral energetic/glucose demand.
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Affiliation(s)
| | - Karin Pierre
- Department of Physiology, University of Lausanne, Switzerland
| | - Ian A. Simpson
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine, Hershey, PA, U.S.A
| | - Luc Pellerin
- Department of Physiology, University of Lausanne, Switzerland
| | - Susan J. Vannucci
- Department of Pediatrics/Newborn Medicine, Weill Cornell Medical College, New York, NY, U.S.A
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