Ketogenic diets in glioblastoma
A ketogenic diet is a very-low-carbohydrate, high-fat diet that makes the body run on ketones. The idea is to starve brain tumours of glucose. It is safe and feasible for a few months, but no trial has shown it makes people live longer.
Glioblastoma is highly glycolytic and normal brain can use ketone bodies, so a ketogenic diet has a plausible rationale that mouse models partly support. Human evidence is limited to feasibility studies and small randomised trials: the ERGO trial (recurrent GBM, feasibility), ERGO2 (50 patients, calorie-restricted ketogenic diet plus fasting during re-irradiation, no PFS benefit), KETOCAN and modified Atkins studies with temozolomide and radiotherapy showing achievable ketosis and acceptable tolerability but no efficacy signal that survives scrutiny. Adherence beyond three months is poor, weight loss is common, and steroid-induced hyperglycaemia undermines ketosis. The honest position is that it is an open question with a weak prior, not a treatment, and patients who choose it should do so inside a trial with dietitian support.
How it works
Carbohydrate restriction lowers blood glucose and raises ketones; the hypothesis is that tumour cells with mitochondrial dysfunction cannot oxidise ketones efficiently while neurons can.
- Feasible and safe for most patients over 3-6 months with supervision
- Testable biomarker (ketosis)
- Plausible synergy with radiotherapy and PI3K-pathway drugs
- No randomised evidence of survival benefit
- Adherence and weight loss
- Heavily marketed to patients ahead of the evidence
Latest papers
topQuery for this technology: (TITLE:"Ketogenic diets in glioblastoma" OR ABSTRACT:"Ketogenic diets in glioblastoma") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Ketogenic diets in glioblastoma, not a curated reading list.
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