Study shows keto diet could enhance pancreatic cancer therapy

A recent preclinical study led by Ludwig Cancer Research has demonstrated that a common weight-loss diet could enhance the efficacy of chemotherapy for pancreatic cancer. 

The study, published in the journal 'Med', showed that a ketogenic diet--or high fat, modest protein and very low carbohydrate intake--synergizes with chemotherapy to triple survival time compared to chemotherapy alone in rigorous mouse models of pancreatic ductal adenocarcinoma (PDAC). 

The researchers, led by Ludwig Princeton Branch Director Joshua Rabinowitz, also described findings from an intricate examination of how ketogenic diets affected the metabolism of PDAC tumours, and identify mechanisms that might account for the therapeutic effect. 

Their findings are now being evaluated in a clinical trial (NCT04631445) testing the benefits of a ketogenic diet in PDAC patients receiving chemotherapy. 

"There's been real progress against pancreatic cancer over the past two decades," said Rabinowitz, who is also a Professor in the Department of Chemistry and the Lewis-Sigler Institute for Integrative Genomics at Princeton University. 

"The problem is that, while a number of patients now see their tumours stabilize or shrink, the benefits of chemotherapy are very short-lived. It often extends patients' lives six months to a year, but way too rarely do we see the three-plus years of extension in survival that people would, at a minimum, hope for." 

Substantial preclinical evidence suggested that fasting, or diets that resemble fasting in their metabolic effects, could enhance therapy for a variety of cancers. 

The ketogenic diet mimics fasting by reducing circulating glucose and depressing levels of insulin, a hormone that drives tissues and tumours to consume the sugar. 

Insulin is an important promoter of cancer growth--especially in pancreatic tumours--while glucose is a critically important fuel for cancer cell proliferation. 

Rabinowitz's own studies previously revealed that PDAC tumours, despite their aggressive growth, are starved of glucose, which suggested they could be especially vulnerable to additional glucose deprivation.