Alkalinization of the tumor microenvironment: are there prospects as a therapeutic objective?

Tumor acidity is one of the hallmarks of cancer. The use of glycolysis as the main source of ATP production due to the
metabolic reprogramming of cancer cells makes their intracellular pH alkaline and extracellular pH acidic. This metabolic
reprogramming and acidification are part of the general defenses that allow malignant cells to survive, multiply, spread, and
become resistant to therapies. Tumor acidity may also be associated with a poor prognosis for cancer patients, and clinicians
should consider this when diagnosing and determining optimal treatment. On the other hand, the inversion of the pH
gradient in tumors could be a weakness, which will allow the development of new promising therapies. Pharmacological
inhibition of pH regulation pathways and alkalinization of the tumor appear to be prospective therapeutic options for
cancer treatment. Alkalization therapy does not contradict standard treatment methods and can be used in combination
to increase effectiveness. Here, we have tried to summarize the basic knowledge about tumor acidity and related potential
cancer treatment options.