Glioblastoma Multiforme Clinical Trial
Official title:
The Feasibility and Biologic Effect of a Modified Atkins-based Intermittent Fasting Diet in Patients With Glioblastoma (GBM)
The primary goal of this study is to assess the feasibility and biologic activity of a modified Atkins-based diet combined with short-term intermittent fasting, a GLioma Atkins-based Diet (GLAD), in patients with central nervous system GBM.
Malignant gliomas have a high glycolytic rate and are dependent on glucose for energy
metabolism. This so called "Warburg effect" or the reliance of central nervous system (CNS)
tumor cells on glucose utilization through glycolysis has been identified as a potential
therapeutic target in cancer metabolism. Preclinically, reduced cerebral glucose via calorie
restriction has been repeatedly associated with tumor reduction and improved survival in
glioma animal models. Such work has led to several early clinical studies evaluating the
ketogenic diet (KD) in patients with recurrent GBM.
The modified Atkins diet (MAD) is designed to provide a more palatable, less restrictive but
effective alternative to the strict KD, particularly for adults. The MAD does not require
inpatient admission for initial fast, weight of foods, or severe dietary restrictions and is
generally well tolerated, easier to administer, and more practical for adults. The MAD lacks
calorie restriction, an important component to dietary therapies in preclinical
investigations. Emerging evidence also suggests that short term fasting may provide superior
anti-cancer activity to long term calorie restriction and that these benefits have been
observed without substantial weight loss that can be observed with longer term calorie
restriction.
In glioma patients, a diet therapy that combines the broad clinical application of the MAD
with the caloric impact of short-term intermittent fasting is therefore optimal. Moreover,
initiation of this diet when the cancer has already undergone induction therapy and is
clinically and radiographically stable, may provide the optimal time for metabolic
intervention to prevent recurrence or progression.
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