Autophagy inhibition improves the targeted radionuclide therapy efficacy of 131 I-FAP-2286 in pancreatic cancer xenografts.

Purposes: Radiotherapy can induce tumor cell autophagy, which might impair the antitumoral effect. This study aims to investigate the effect of autophagy inhibition on the targeted radionuclide therapy (TRT) efficacy of ¹³¹ I-FAP-2286 in pancreatic cancer.
Methods: Human pancreatic cancer PANC-1 cells were exposed to ¹³¹ I-FAP-2286 radiotherapy alone or with the autophagy inhibitor 3-MA. The autophagy level and proliferative activity of PANC-1 cells were analyzed. The pancreatic cancer xenograft-bearing nude mice were established by the co-injection of PANC-1 cells and pancreatic cancer-associated fibroblasts (CAFs), and then were randomly divided into four groups and treated with saline (control group), 3-MA, ¹³¹ I-FAP-2286 and ¹³¹ I-FAP-2286 + 3-MA, respectively. SPECT/CT imaging was performed to evaluate the bio-distribution of ¹³¹ I-FAP-2286 in pancreatic cancer-bearing mice. The therapeutic effect of tumor was evaluated by ¹⁸ F-FDG PET/CT imaging, tumor volume measurements, and the hematoxylin and eosin (H&E) staining, and immunohistochemical staining assay of tumor tissues.
Results: ¹³¹ I-FAP-2286 inhibited proliferation and increased the autophagy level of PANC-1 cells in a dose-dependent manner. 3-MA promoted ¹³¹ I-FAP-2286-induced apoptosis of PANC-1 cells via suppressing autophagy. SPECT/CT imaging of pancreatic cancer xenograft-bearing nude mice showed that ¹³¹ I-FAP-2286 can target the tumor effectively. According to ¹⁸ F-FDG PET/CT imaging, the tumor growth curves and immunohistochemical analysis, ¹³¹ I-FAP-2286 TRT was capable of suppressing the growth of pancreatic tumor accompanying with autophagy induction, but the addition of 3-MA enabled ¹³¹ I-FAP-2286 to achieve a better therapeutic effect along with the autophagy inhibition. In addition, 3-MA alone did not inhibit tumor growth.
Conclusions: ¹³¹ I-FAP-2286 exposure induces the protective autophagy of pancreatic cancer cells, and the application of autophagy inhibitor is capable of enhancing the TRT therapeutic effect.
(© 2024. The Author(s).)