A pharmacodynamic study of rapid lactate metabolic modulation by intravenous L-arginine in brain metastases
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By
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Xueping Liu
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Guobo Du
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Nai Mu
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Lang He
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May 28, 2026
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Clinical Scorecard: Investigation of the Rapid Effects of Intravenous L-arginine on Lactate Metabolism in Brain Metastases: A Pharmacodynamic Approach
At a Glance
| Category | Detail |
|---|
| Condition | Brain Metastases |
| Key Mechanisms | Nitric oxide-mediated glycolysis inhibition |
| Target Population | Patients with solid tumor brain metastases |
| Care Setting | Single-center, open-label, randomized trial |
Key Highlights
- Significant lactate reduction observed in pooled L-arginine group at T3 (p = 0.0012)
- 30 g dose of L-arginine showed peak lactate reduction of 63.5% at 30 minutes
- No treatment-related adverse events reported up to 24 hours post-infusion
Guideline-Based Recommendations
Diagnosis
- Histologically or cytologically confirmed solid malignancy with measurable brain metastasis
Management
- Intravenous L-arginine administered at doses of 10 g, 20 g, or 30 g
Monitoring & Follow-up
- Serial magnetic resonance spectroscopy (MRS) for lactate dynamics
Risks
- Exclusion of patients with contraindications to L-arginine or MRI
Patient & Prescribing Data
Patients aged 18–75 with solid tumors and brain metastases unsuitable for surgical resection
Intravenous administration ensures rapid and complete systemic delivery of L-arginine
Clinical Best Practices
- Consider L-arginine as a potential radiosensitizer in future trials
- Monitor lactate levels post-infusion to assess metabolic response
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