A team of researchers at Duke University has found that lactic acid (lactate) is an important energy source that keeps tumour cells alive, so cutting off their supply of lactate could kill them.
In many tumours, cells can produce energy in different ways. Tumour cells near blood vessels get plenty of oxygen and can burn glucose or lactate like normal cells, while cells far from blood vessels lack oxygen and can't burn fuel efficiently, producing lactate as waste. Well-oxygenated cells prefer to burn this lactate, which leaves the oxygen-poor cells the glucose they need. So if the well-oxygenated cells can't use lactate, the system breaks down.
How does lactate move around a tumour? In muscles, a lactate shuttle helps prevent cramps, and scientists believe the same happens in tumours: the protein that carries lactate in muscle, MCT1, is also found in tumour cells.
Blocking MCT1 doesn't kill the well-oxygenated cells, but it forces them to switch to glucose. As they use up most of the glucose before it reaches the oxygen-poor cells, those cells starve to death.
The big advantage of this strategy is that a drug doesn't need to reach the oxygen-poor cells far from the bloodstream or get inside them: it works by blocking the lactate carrier on the outside of cells. In mice, combining MCT1 blockers with radiotherapy was enough to kill the remaining tumour cells near blood vessels.
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