Effects of Alkalization Therapy on Chemotherapy Outcomes in Metastatic or Recurrent Pancreatic Cancer

Background/Aim: The acidic tumor microenvironment is associated both with the progression and drug resistance of cancer. We aimed to investigate the effects of alkalization therapy performed concurrently with chemotherapy on the survival of advanced pancreatic cancer patients (study registration: UMIN 000035659). Patients and Methods: Twenty-eight patients with metastatic or recurrent pancreatic cancer were assessed in this study. Alkalization therapy consisted of an alkaline diet with supplementary oral sodium bicarbonate (3.0-5.0 g/day). Results: The mean urine pH was significantly higher after the alkalization therapy (6.85 +/- 0.74 vs. 6.39 +/- 0.92; p<0.05). The median overall survival from the start of alkalization therapy of the patients with high urine pH (>7.0) was significantly longer than those with low urine pH (<= 7.0) (16.1 vs. 4.7 months; p<0.05). Conclusion: An alkalization therapy may be associated with better outcomes in advanced pancreatic cancer patients treated with chemotherapy.