- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05428852
Keto-Brain:Investigating the Use of Ketogenic Diets in Brain Metastases
Keto-Brain: Investigating the Use of Ketogenic Diets in Brain Metastases
Study Overview
Status
Conditions
Detailed Description
Neurological tissues are among the most common (>10% of cancer patients) and debilitating sites for metastatic disease to develop. The brain is a 'sanctuary site' for many cancer cells and remains a challenging site to treat. Surgery and radiation therapies are the most common treatments. The investigators hypothesize that the metabolic adaptations associated with a well-formulated ketogenic diet that induces nutritional ketosis will significantly improve the response to surgery and radiation in patients with brain metastases. To date, numerous preclinical studies have demonstrated the ability of nutritional ketosis and caloric restriction to augment the therapeutic efficacy of radiotherapy. Use of a ketogenic diet is known to decrease the protein expression of HIF-1 and VEGFR2, and may increase radio sensitivity by normalizing tumor vasculature and increasing facilitated oxygen delivery to tumor cells. Several additional proposed mechanisms exist for enhancing radiosensitivity of the malignancy including: HDAC dependent mechanisms, ATP deprivation, mitochondrial ROS production and downregulation of IGF-1 receptor. Short-term fasting, a way to increase ketones acutely, has been demonstrated to speed up mitotic rates and thus facilitate a DNA damage sensitization. Lastly, a recent study showed that glucose restriction lowered Ki-67 expression, clonogenic frequency and rate of proliferation in gliomaspheres in vitro.
The investigating team team has an established expertise in conducting ketogenic diet interventions. Many individuals have adopted a low-carbohydrate diet for health reasons, yet there is scarce professional support available to provide guidance and support, especially for ketogenic diets. The investigators have scientific expertise and practical knowledge of both ketogenic and current standard of care cancer diets combined with a passion to empower people with the tools to implement these eating approaches into the participant's lifestyle. This project is highly patient-centered. The investigators will support patients who are randomized into either one of the intervention groups and provide them with a personalized eating plan designed to have maximal therapeutic impact and positively impact their lives. To that end, this project is unique in that it is highly patient-centered while also designed to have a substantial scientific and practical impact on medical management of brain metastasis treatments.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Ohio
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Columbus, Ohio, United States, 43210
- Recruiting
- Ohio State University Comprehensive Cancer Center
-
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Measurable brain lesions noted on baseline MRI imaging
- Graded Prognostic Assessment > 1.5
- Body mass index (BMI) ≥18 kg/m2
- Eastern Cooperative Oncology Group (ECOG) Performance status of 0-1 (0=participant has either normal activity, 1= participant has some symptoms but is nearly full ambulatory)
- Able and willing to follow prescribed diet intervention
- Scheduled to receive SRS
Exclusion Criteria:• Undergoing whole brain radiation therapy
- BMI <18 kg/m2
- Pregnant or nursing women
- Not willing to be randomized into either of the dietary interventions
- Unable to provide Informed Consent
- No previous diagnosis of small cell lung carcinoma
- No previous or suspected leptomeningeal disease
- Type 1 diabetes or insulin-dependent Type II diabetes
- Abnormal renal function (GFR < 55 mL/min, creatinine >2.0, urinary albumin >1 g/day) Not MRI eligible
Study Plan
How is the study designed?
Design Details
- Primary Purpose: SUPPORTIVE_CARE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Standard of Care
Patients receive standard of care therapy with SRS and AICR Diet education.
|
Ancillary studies
Correlative Studies
NRG-CC
Fitbit Activity Tracking
|
EXPERIMENTAL: Standard of Care + Ketogenic Diet
(standard of care, ketogenic diet) Patients receive standard of care with SRS.
Patients undergo a controlled feeding period ketogenic diet comprising of meals for the first week and then transition into a free living with guided support type of intervention.
|
Ancillary studies
Correlative Studies
NRG-CC
Fitbit Activity Tracking
Undergo ketogenic diet
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility of maintaining a ketogenic versus AICR diet in patients with brain metastasis selected for radiosurgery
Time Frame: Up to 16 weeks
|
Summaries from questionnaires will be plotted over time to assess adherence and compliance to the ketogenic diet.
|
Up to 16 weeks
|
Feasibility of maintaining a ketogenic diet in patients with brain metastasis selected for radiosurgery
Time Frame: Up to 16 weeks
|
Summaries from ketone logs will be plotted over time to assess adherence and compliance to the ketogenic diet.
|
Up to 16 weeks
|
Metabolic outcomes of a ketogenic versus AICR diet in patients with brain metastasis selected for radiosurgery
Time Frame: Up to 16 weeks
|
Summaries from blood markers will be plotted over time to assess adherence and compliance to the ketogenic diet.
|
Up to 16 weeks
|
Number of Participants with partial-or-complete response according to RECIST v1.1
Time Frame: Baseline up to 16 weeks
|
use a Chi-squared test for the association between treatment group and partial-or-complete response according to RECIST v1.1
|
Baseline up to 16 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Preliminary effects of the ketogenic versus AICR diet on Neurocognitive Function Scores in BM individuals undergoing radiation therapy
Time Frame: Baseline up to 16 weeks
|
same linear mixed effects model as for the primary objective, but with the following quality-of-life endpoints as outcomes
|
Baseline up to 16 weeks
|
Preliminary effects of the ketogenic versus AICR diet on PROMIS Cognitive Function Short Form 8a Scores in BM individuals undergoing radiation therapy
Time Frame: Baseline up to 16 weeks
|
same linear mixed effects model as for the primary objective, but with the following quality-of-life endpoints as outcomes
|
Baseline up to 16 weeks
|
Preliminary effects of the ketogenic versus AICR diet on Heart Hope Scale in BM individuals undergoing radiation therapy to asses quality of life
Time Frame: Baseline up to 16 weeks
|
same linear mixed effects model as for the primary objective, but with the following quality-of-life endpoints as outcomes
|
Baseline up to 16 weeks
|
Collaborators and Investigators
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2020C0046
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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