Scientific rationale
- The rationale draws on altered tumour glucose metabolism, insulin and IGF signalling, mitochondrial stress, inflammation, and the brain's ability to use ketones.
- Tumour biology is heterogeneous, so a single metabolic strategy is unlikely to apply equally across diagnoses.
Research snapshot
- Glioblastoma studies suggest ketogenic therapy can be feasible in selected patients alongside standard oncology care, but trials remain small.
- There is no established evidence that ketogenic diet alone improves survival, and it must not delay surgery, radiotherapy, chemotherapy, steroids, or trial care.
Clinical frame
- Cancer patients may face cachexia, steroid-induced hyperglycaemia, nausea, dysphagia, seizures, and treatment-related fatigue, all of which change nutrition risk.
- Any ketogenic strategy in brain cancer should be oncology-led and dietitian-supervised.
Open questions
- Which tumour genotypes, imaging markers, or metabolic phenotypes identify patients worth studying?
- How can trials separate ketosis, calorie intake, weight change, and standard treatment effects?
Selected evidence
- Efficacy and safety of ketogenic diet in glioblastoma: updated systematic review and meta-analysis Neurological Sciences, 2026
- Phase 1 safety and feasibility trial of a ketogenic diet plus standard of care for newly diagnosed glioblastoma Neuro-Oncology Advances, 2025
- Ketogenic metabolic therapy as an adjuvant to standard care in glioblastoma: systematic review of clinical trials Nutrients, 2025
- Ketogenic diet therapy for high-grade gliomas combined with standard treatment using an angiogenesis inhibitor Nutrients, 2026
- Systematic review and clinical insights: ketogenic diet in glioblastoma cancer neuroscience Journal of Personalized Medicine, 2024
- Clinical framework for ketogenic metabolic therapy in glioblastoma PubMed record, 2024