Dietary Intervention Shows Promise in Glioblastoma Treatment
Researchers are exploring the potential of dietary strategies, in combination with existing treatments, to slow the aggressive growth of glioblastoma, the most deadly form of brain cancer. A new study, published in the journal Science Advances, has revealed a previously unknown vulnerability in glioblastoma cells related to vitamin B3 metabolism, offering a potential new avenue for therapeutic intervention.
Glioblastoma affects 0.59 to 5 per 100,000 individuals worldwide and presents significant treatment challenges. Its invasive growth patterns often make complete surgical removal impossible, and the blood-brain barrier hinders drug delivery. The cancer can suppress the immune system, limiting the body’s natural defenses. These factors contribute to its poor prognosis and the urgent need for novel treatment approaches.
Steroids and Metabolic Weakness
The research, conducted by a team from five European countries including the Cancer Research UK Scotland Institute in Glasgow, focused on how glioblastoma cells process vitamins. The team discovered that commonly used steroid medications dramatically alter how glioblastoma cells metabolize vitamin B3. This alteration creates a metabolic weakness that can be exploited therapeutically.
Specifically, the study found that when steroids are administered, restricting the amino acid methionine in a patient’s diet deprives glioblastoma cells of the metabolites they need to grow. This suggests a synergistic effect between steroid treatment and dietary modification.
Glucose Metabolism and Tumor Growth
This research builds upon earlier findings regarding glucose metabolism in glioblastoma cells. A study published in Nature, highlighted by researchers at the University of Michigan, compared how glioblastoma cells and healthy brain cells utilize glucose. The findings showed that while healthy brain cells use sugar to generate energy for essential processes like neurotransmitter synthesis, glioblastoma cells prioritize using glucose to create molecules necessary for tumor growth and invasion. This difference in metabolic pathways presents a potential target for therapeutic intervention.
Ketogenic Diet and Glioblastoma
The potential of dietary interventions, particularly the ketogenic diet (KD), has been investigated in the context of glioblastoma treatment. Research indicates that a KD, either alone or in combination with radiation therapy and temozolomide, can prolong survival and slow tumor growth in mouse models compared to a standard diet.
Currently, a Phase 2 clinical trial, DIET2TREAT (NCT05708352), is underway to evaluate the efficacy of a ketogenic diet versus standard dietary guidance in combination with standard-of-care treatment for newly diagnosed glioblastoma patients. This multi-center, randomized trial involves 170 patients and aims to provide more definitive evidence regarding the benefits of a ketogenic approach.
Phase 1 Safety and Feasibility
A Phase 1 safety and feasibility trial has also been conducted to assess the viability of a ketogenic diet in patients with newly diagnosed glioblastoma receiving standard-of-care treatment. This initial trial focused on determining whether patients could adhere to the diet and whether it was safe to implement alongside conventional therapies.
Implications and Future Research
Dr. Saverio Tardito, a researcher involved in the Science Advances study, stated that the findings reveal a “previously hidden vulnerability” in glioblastoma tumors, potentially leading to new diagnostic and treatment strategies, including diet-based approaches. The combination of steroid treatment with dietary strategies limiting methionine availability demonstrated the ability to slow tumor growth in preclinical models.
Sam Godfrey, science engagement lead at Cancer Research UK, emphasized the urgent need for new and better treatments for glioblastoma, stating that discoveries that could potentially slow its growth and provide families with more time are “desperately needed.”
While these findings are promising, it’s important to note that research is ongoing. The DIET2TREAT trial and further studies will be crucial in determining the optimal dietary strategies and their effectiveness in improving outcomes for glioblastoma patients. The interplay between steroid medications, amino acid restriction, and glucose metabolism represents a complex area of investigation with the potential to significantly impact the future of glioblastoma treatment.
