A Ketogenic Diet as a Complementary Treatment on Patients With High-grade Gliomas and Brain Metastases

NCT ID: NCT05564949

Last Updated: 2025-05-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-09-20

Study Completion Date

2026-02-28

Brief Summary

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The survival interval of patients with gliomas ranges between 12 to 15 months. Recent findings revealed that dietary interventions to reduce glucose and glycolytic pathways could have a therapeutic effect. Ketosis can be an effective therapy to extend the survival of patients with gliomas.

Detailed Description

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Gliomas are invasive and aggressive tumors, which derive from glial or stem cells, and after neoplastic transformation, acquire glial cell characteristics. Treatment of high-grade gliomas includes measures to relieve symptoms and eliminate or control the tumor. Surgery, radiation, and chemotherapy are the most common options. Recent findings revealed that dietary interventions to reduce glucose and glycolytic pathways could have a therapeutic effect. CKD is a restrictive therapeutic diet consisting of a 4:1 ratio of fat-to-CHO and protein. Fat provides up to 90% of the caloric intake, while overall CHO intake is less than 50 g/day. CKD reducing blood glucose levels and increasing ketone body levels stimulates biochemical changes to achieve systemic ketosis. Though, evidence for CKD in clinical practice is still limited. This study focuses on the classic ketogenic diet (CKD), adjusted for each patient's energy needs by dieticians to achieve ketosis. The primary outcome is to assess the efficacy of CKD to extend the survival of patients with high-grade gliomas and brain metastases. Historical controls will be used to compare the outcome measurements.

Conditions

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Brain Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Patients will adhere to a classic ketogenic diet for a period of 3 months with a possible extension depending on their compliance on the diet.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Classic Ketogenic Diet

Patients will adhere to a classic ketogenic diet for a period of 3 months with a possible extension depending on their compliance on the diet.

Group Type EXPERIMENTAL

CKD

Intervention Type OTHER

Patients/families will meet with the study dietician to discuss the CKD, ask questions, and plan clinic visits. Training will take place about diet, meal planning, and ketones/glucose monitoring. The dietitian will follow the patient throughout treatment. Patients will measure their urine ketosis with urine test strips and capillary ketones with blood ketone meters daily, and they will complete records from the start till the end of the study. Finally, they will meet with the dietitian at follow-up visits and on an as-needed basis.

Interventions

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CKD

Patients/families will meet with the study dietician to discuss the CKD, ask questions, and plan clinic visits. Training will take place about diet, meal planning, and ketones/glucose monitoring. The dietitian will follow the patient throughout treatment. Patients will measure their urine ketosis with urine test strips and capillary ketones with blood ketone meters daily, and they will complete records from the start till the end of the study. Finally, they will meet with the dietitian at follow-up visits and on an as-needed basis.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 18-80
* Karnofsky Performance Score of 50 or more.
* Newly diagnosed, histologically confirmed glioblastoma grade 4, or secondary metastases or progression after surgical resection, radiation and chemotherapy.
* Normal function of liver and kidneys
* Ability to sign informed consent form

Exclusion Criteria

* Diabetes mellitus
* Life expectancy \>3 months
* Inability to adhere to diet
* Inability to give informed consent form
* Cholecystectomy last 1 year (before the study entry)
* Diagnosis of genetic disorder of fat metabolism
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Attikon Hospital

OTHER

Sponsor Role lead

Responsible Party

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Arezina Kasti

Registered Dietitian, MSc, PhDc

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Efstathios Boviatsis, MD

Role: STUDY_DIRECTOR

UNIVERSITY GENERAL HOSPITAL ATTIKON

Locations

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Arezina Kasti

Chaïdári, Athens, Greece

Site Status RECRUITING

Attikon University General Hospital

Athens, , Greece

Site Status RECRUITING

Countries

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Greece

Central Contacts

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Arezina N. Kasti, RD

Role: CONTACT

+306942917860 ext. +30

Evangelos K. Papadopoulos, MD

Role: CONTACT

6936251274 ext. +30

Facility Contacts

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Arezina N. Kasti, RD

Role: primary

+306942917860 ext. +30

Evangelos K. Papadopoulos, MD

Role: backup

6936251274 ext. +30

Arezina N. Kasti, RD

Role: primary

2105832575 ext. +30

Evangelos K. Papadopoulos, MD

Role: backup

6936251274 ext. +30

References

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Thomas JG, Veznedaroglu E. Ketogenic Diet for Malignant Gliomas: a Review. Curr Nutr Rep. 2020 Sep;9(3):258-263. doi: 10.1007/s13668-020-00332-2.

Reference Type BACKGROUND
PMID: 32720120 (View on PubMed)

Sargaco B, Oliveira PA, Antunes ML, Moreira AC. Effects of the Ketogenic Diet in the Treatment of Gliomas: A Systematic Review. Nutrients. 2022 Feb 27;14(5):1007. doi: 10.3390/nu14051007.

Reference Type BACKGROUND
PMID: 35267981 (View on PubMed)

Ebrahimpour-Koujan S, Shayanfar M, Benisi-Kohansal S, Mohammad-Shirazi M, Sharifi G, Esmaillzadeh A. Adherence to low carbohydrate diet in relation to glioma: A case-control study. Clin Nutr. 2019 Dec;38(6):2690-2695. doi: 10.1016/j.clnu.2018.11.023. Epub 2018 Nov 30.

Reference Type BACKGROUND
PMID: 30551899 (View on PubMed)

Perry A, Wesseling P. Histologic classification of gliomas. Handb Clin Neurol. 2016;134:71-95. doi: 10.1016/B978-0-12-802997-8.00005-0.

Reference Type BACKGROUND
PMID: 26948349 (View on PubMed)

Other Identifiers

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ΕΒΔ246/14-04-2022

Identifier Type: -

Identifier Source: org_study_id

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