Extracellular pH (pHe) of tumor cells is characteristic of tumor microenvironment (TME). Acidic TMEimpairs the responses of tumors to some anti-cancer chemotherapies. In this study, we showed that daily oral dosing of sodium potassium citrate (K/Na citrate) increased blood HCO 3 concentrations, corresponding to increase of HCO 3 concentrations and pHs in urine, and neutralized the tumor pHe. Neutralization of acidic TME by alkaline substance like HCO 3 , an active metabolite of K/Na citrate, well potentiated the therapeutic effect of anticancer agent TS-1 ® , an orally active 5-fuluoro-uracil derivative, in Panc-1 pancreatic cancer-xenograft murine model. Neutralization of acidic TME by using an alkaline K/Na citrate is a smart approach for enhancement of the therapeutic effects of anticancer agents for pancreatic cancer in the end stage.