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Case Report Open Access

Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report

  • Authors:
    • Matthew C.L. Phillips
    • Ziad Thotathil
    • Prashanth Hari Dass
    • Fouzia Ziad
    • Ben G. Moon
  • View Affiliations / Copyright

    Affiliations: Department of Neurology, Waikato Hospital, Hamilton 3204, New Zealand, Department of Radiation Oncology, Waikato Hospital, Hamilton 3204, New Zealand, Department of Oncology, Rotorua Hospital, Rotorua 3046, New Zealand, Department of Pathology, Waikato Hospital, Hamilton 3204, New Zealand, Midland MRI, Waikato Hospital, Hamilton 3204, New Zealand
    Copyright: © Phillips et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 230
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    Published online on: March 26, 2024
       https://doi.org/10.3892/ol.2024.14363
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Abstract

Glioblastoma (GBM) is the most common primary malignant brain tumour in adults. The standard of care consists of surgical resection and concurrent chemoradiation, followed by adjuvant temozolomide chemotherapy. This protocol is associated with a median survival of 12‑15 months, and <5% of patients survive >3 years. Ketogenic metabolic therapy (KMT) targets cancer cell metabolism by restricting glucose availability and evoking differential stress resistance and sensitization, which may augment the standard treatments and lead to therapeutic benefit. The present study reports the case of a 64‑year‑old woman with isocitrate dehydrogenase (IDH)‑wildtype GBM who pursued the standard treatment protocol in conjunction with an intensive, multimodal KMT program for 3 years. The KMT program consisted of a series of prolonged (7‑day, fluid‑only) fasts, which were specifically timed to maximize the tolerability and efficacy of the standard treatments, combined with a time‑restricted ketogenic diet on all other days. During the first and second treatment years the patient sustained a glucose ketone index (GKI) of 1.65 and 2.02, respectively, which coincided with complete clinical improvement, a healthy body‑mass index and a high quality of life, with no visible progressive tumour detected on imaging at the end of the second year. In the setting of the death of an immediate family member leading to increased life stress, slightly relaxed KMT adherence, and a higher GKI of 3.20, slow cancer progression occurred during the third year. The adverse effects attributed to KMT were mild. Despite the limitations of this case report, it highlights the feasibility of implementing the standard treatment protocol for GBM in conjunction with an intensive, long‑term, multimodal and specifically timed KMT program, the potential therapeutic efficacy of which may depend upon achieving as low a GKI as possible.
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Copy and paste a formatted citation
Spandidos Publications style
Phillips MC, Thotathil Z, Hari Dass P, Ziad F and Moon BG: Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report. Oncol Lett 27: 230, 2024.
APA
Phillips, M.C., Thotathil, Z., Hari Dass, P., Ziad, F., & Moon, B.G. (2024). Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report. Oncology Letters, 27, 230. https://doi.org/10.3892/ol.2024.14363
MLA
Phillips, M. C., Thotathil, Z., Hari Dass, P., Ziad, F., Moon, B. G."Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report". Oncology Letters 27.5 (2024): 230.
Chicago
Phillips, M. C., Thotathil, Z., Hari Dass, P., Ziad, F., Moon, B. G."Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report". Oncology Letters 27, no. 5 (2024): 230. https://doi.org/10.3892/ol.2024.14363
Copy and paste a formatted citation
x
Spandidos Publications style
Phillips MC, Thotathil Z, Hari Dass P, Ziad F and Moon BG: Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report. Oncol Lett 27: 230, 2024.
APA
Phillips, M.C., Thotathil, Z., Hari Dass, P., Ziad, F., & Moon, B.G. (2024). Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report. Oncology Letters, 27, 230. https://doi.org/10.3892/ol.2024.14363
MLA
Phillips, M. C., Thotathil, Z., Hari Dass, P., Ziad, F., Moon, B. G."Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report". Oncology Letters 27.5 (2024): 230.
Chicago
Phillips, M. C., Thotathil, Z., Hari Dass, P., Ziad, F., Moon, B. G."Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report". Oncology Letters 27, no. 5 (2024): 230. https://doi.org/10.3892/ol.2024.14363
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