Experimental work fragment was carried out in 60 rats with sarcoma 45 (S45) transplanted under the back skin. Cyclophosphamide (C) was administered intraperitoneally twice at a dose of 5 mg/kg. On the tumor peritumoral area perimeter (in 4 points) 0.25 ml of a 1% solution of ATP or 1% solution of diphenhydramine (D) were administered. Clinical studies were performed on 60 patients diagnosed with breast cancer. These patients underwent two cycles of CMFA chemotherapy: C 800 mg/m2, methotrexate 30 mg/m2, fluorouracil 2000 mg/m2, doxorubicin 80 mg/m[b]; on a background of peritumoral injection of 0.5 ml of a 1% solution of ATP or 1% solution of D.
Modelling of metabolic acidosis in peritumoral area was shown to result in dissociation of respiration processes and oxidative phosphorylation of cells (suppression of SDH activity by ATP by 62% and D by 57.9% and an increase in activity of αGFDG by ATP and D by 154.7%) the ratio of SDH and αGFDG less than 1. Morphologic study of S45 showed the development of wide connective border in the subcapsular zone with the inclusion of red blood cells, lymphocytes, fibroblasts, histiocytes. The signs of tumor cell death by activation of apoptosis were observed: shrinkage and reduction in cell volume, chromatin hyper condensation, fragmentation of organelles and nucleus, a large amount of coarse bundles of microfilaments, the presence of apoptotic cells. Tumor tissue was infiltrated predominantly with CD3 and CD161a cells, CD45a indicators decreased by 3–4.5 times.
The analysis of antitumor effect in breast cancer patients depending on factors of energy processes inhibition revealed that complete tumor regression only in combination with ATP occurred in 14.2%, and D-in 18.8%, partial regression using ATP was 71–5%, D – 62.5%. Tumor progression was not observed.
Modulating abnormalities in energy metabolism due to metabolic acidosis of tumor microenvironment on the background of systemic chemotherapy, one can achieve activation of additional pathogenetic mechanisms of inhibition of tumor growth and tumor cell death. It is necessary to emphasize the importance of the further search for factors of pathogenetic mechanisms and therapy of the influence on the tumor, including the modulation of acidosis of peritumoraly area that opens up new perspectives in solving this problem.