This study aimed to develop a new therapeutic strategy with a novel Lactate Dehydrogenase A inhibitor (LDHi) for cancers bearing the Warburg phenotype by monitoring the impact on in vivo metabolic flux of the LDHi using hyperpolarized 13C-MRI. 13C-MRI with hyperpolarized [1-13C]pyruvate revealed in vivo pharmacodynamics and an effective dose of the LDHi without the need for tissuse sampling. In addition, based on these results, we developed a therapeutic strategy with the LDHi for mice harboring a MiaPaCa-2 (a glycolytic pancreatic cancer cell line) xenograft. This methodology can be a novel approach to treat glycolytic cancers.
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