Development of the first 18F-labeled MCT1/MCT4 lactate transport inhibitor: Radiosynthesis and preliminary in vivo evaluation in mice

Objectives: Although, lactate is occasionally considered as a waste in physiological cell metabolism, it is also known as an important substrate that fuels the oxidative metabolism of oxygenated tumor cells. Therefore, tumor cells express a set of plasma membrane transporters for lactate. Those monocarboxylate transporters (MCTs) are regarded as functional biomarkers for the metabolic symbiosis between glycolytic and oxidative tumor cells [1]. Overexpression of MCT1 and MCT4 has been shown for a variety of human cancers (e.g. colon, brain, breast, and kidney) [2]. Experimentally, inhibition of MCT1/MCT4 resulted in intracellular lactate accumulation, acidosis and cell death. In the current study, the first 18F-labeled MCT1/MCT4 inhibitor was developed for potential in vivo imaging of MCT expression in cancer.
Methods: Fluorinated α-CHC derivatives (FACH and tert-Bu-FACH) were synthesized and the inhibitory activity of FACH towards MCT1 and MCT4 was estimated by [14C]lactate uptake assays using an immortalized rat brain endothelial cell line (RBE4). For the radiosynthesis of [18F]FACH, a protected mesylate precursor was developed to prevent any possible effect on the labeling reaction. [18F]FACH was produced via a two-step radiosynthesis approach, starting with the nucleophilic substitution on the alkyl chain using [18F]TBAF followed by removal of the protecting group by trifluoroacetic acid (TFA) at room temperature (Figure 1A).
Isolation of [18F]FACH was performed by semi-preparative HPLC (Reprosil-Pur C18-AQ column, 250 × 10 mm, 46% CH3CN/aq. 20 mM NH4HCO2, pH = 4-5, flow 3.5 mL/min). The tracer was finally purified via solid-phase extraction (Sep-Pak® C18 light cartridge) and formulated in 10% EtOH/saline solution. In vitro stability tests were performed in pig plasma, saline, PBS and n-octanol. The LogD value was assessed by the shake-flask method. The in vivo metabolism of the radiotracer was investigated in female CD-1 mice at 30 min p.i. The biodistribution of [18F]FACH and the inhibitory effects of FACH and α-CHC were investigated by dynamic PET imaging (60 min, nanoScan® PET/MRI, MEDISO, Budapest, Hungary) of female CD-1 mice (Figure 1B).
Results: FACH showed strong inhibition of MCT1 and MCT4 (IC50 = 11 and 6.4 nM respectively). The intermediate [18F]tert-Bu-FACH was obtained by an optimized procedure (CH3CN, 3.75 µmol of TBAHCO3, 2-5 GBq of K[18F]F, 100 ̊C, 15 min) with 55-85% radiochemical yield (n = 10, non-isolated). [18F]FACH was obtained after deprotection of [18F]tert-Bu-FACH with TFA in acetonitrile at room temperature for 15 min. After purification and formulation, the novel radiotracer could be achieved with a RCY of 39 ± 3% (n = 10, EOB), molar activity of 42-100 GBq/µmol (EOS), and RCP >98%. The measured logD value (0.42) reveals moderate lipophilicity of the radiotracer. [18F]FACH was highly stable in saline (>98%) up to 60 min. In vivo metabolite studies showed >98% of intact tracer in plasma, brain, liver and kidney at 30 min p.i. Beside [18F]FACH, a few polar metabolites were also found in urine after 30 min p.i. The organ distribution pattern of [18F]FACH in healthy mice corresponds to the specific expression of MCT1 and MCT4 in kidney, lung, pancreas and liver. In these tissues, a moderate to high reduction of uptake was observed after after pre-injection of FACH and α-CHC, respectively.
Conclusions: The high uptake of [18F]FACH in kidney and other peripheral MCT-expressing organs together with the strong inhibition by specific drugs provide evidence that the new MCT1/MCT4-targeting radiotracer could be proven in ongoing studies to be useful for imaging of solid tumors with PET.