Role of ketogenic metabolic therapy in malignant glioma: A systematic review
Background: Coined as the “Warburg effect” and a recognized hallmark of cancer, energy metabolism
is aberrantly geared towards aerobic glycolysis in most human cancers, including malignant glioma.
Ketogenic metabolic therapy (KMT), i.e. nutritional intervention with ketogenic or low-glycemic diets,
has been proposed as an anti-neoplastic strategy in glioma patients.
Materials and methods: We here review the rationale and existing data investigating KMT in management
of patients with malignant glioma and discuss the promise and potential challenges ofthis novel strategy.
Results from published clinical studies and ongoing clinicaltrials on the topic are systematically reviewed,
including 6 published original articles and 10 ongoing clinicaltrials. Search criteria for this review entailed
the databases MEDLINE, EMBASE, Cochrane CENTRAL, and Google Scholar, as well as ICTRP (WHO) and
ClinicalTrials.gov (NIH) registries.
Results: A substantial amount of preclinical literature demonstrates KMT efficacy and safety in model
systems of malignant glioma. Clinical literature indicates KMT safety and feasibility; 2 clinical studies
suggest KMT-associated anti-neoplastic efficacy and clinical benefit. Ongoing clinical trials address KMT
safety and metabolic impact, patient compliance, and patient clinical/survival benefit. http://www.croh-online.com/article/S1040-8428(16)30232-3/pdf