Metabolic modulation of the biological effects of ionizing radiation and chemotherapy (review)

The review presents general information about the tumor cell microenvironment, its role in the development and progression of the malignant process and the results of antitumor therapy. The analysis showed that the development of methods for influencing the key metabolic targets of tumor cells and their microenvironment is a promising direction in experimental and clinical oncology. Some approaches to inducing metabolic modulation are considered: inhibitors of cellular pumps, hyperglycemia and hyperthermia. The therapeutic effect of the first two induction options is based on modulation of the acid-base balance (pH) of the tumor. The biological effect of hyperthermia is broader and directly depends on the severity and direction of the temperature-exposure mode of heating. Ultimately, such changes lead to an increase in the damaging effect of ionizing radiation and drugs on the tumor. Despite the fact that the composition of the microenvironment is heterogeneous and varies depending on the type of tumor, some specific cells and mediators are present in all its types. Therefore, the developed treatment methods can be universal for most tumor locations. The literature analysis suggests that there is objective experimental and clinical evidence supporting the use of metabolic modulators in antitumor therapy.