Dietary Intervention for Patients Receiving Chemoradiotherapy for Lung Cancer
Name of a Trial
Phase we Trial of a Ketogenic Diet with Concurrent Chemoradiation for Non-Small Cell Lung Cancer (KETOLUNG; NCT01419587). See a custom summary.
Drs. Sudershan K. Bhatia, Daniel James Berg, John Michael Buatti, and Douglas R. Spitz, University of Iowa Holden Comprehensive Cancer Center
Dr. Sudershan K. BhatiaDr. Douglas R. Spitz
Why This Trial Is Important
One of a elemental differences between cancer cells and normal cells is in how they mangle down (metabolize) nutrients to obtain a appetite they need to grow and survive. Normal cells typically rest on oxidative metabolism of glucose, greasy acids, or amino acids to furnish energy. In this process, that takes place inside mobile structures called mitochondria, chemical reactions that need oxygen are used to maximize a volume of appetite constructed from any proton being metabolized.
Cancer cells, on a other hand, have defects in mitochondrial oxidative metabolism, heading to additional prolongation of potentially damaging molecules famous as reactive oxygen species. This can emanate a condition called metabolic oxidative stress. To recompense for this forsake in mitochondrial metabolism, cancer cells use mitochondrial oxidative metabolism, as good as another metabolic routine called glycolysis, to mangle down glucose.
Cancer cells are believed to use most some-more glucose than normal cells because, in further to regulating it for appetite production, cancer cells can use a products of glucose metabolism to detoxify reactive oxygen species. Researchers are exploring ways that this disproportion in mobile metabolism between cancer cells and normal cells competence be exploited to selectively kill cancer cells.
Carbohydrates in a diet yield a straightforwardly accessible supply of glucose that can be used to fuel cancer dungeon growth. Therefore, one process being investigated is a use of a specialized diet that dramatically reduces a volume of glucose in a blood, called a ketogenic diet. This form of diet has been used for decades to assistance children and immature adults with treatment-resistant epilepsy that causes grand mal seizures.
Ketogenic diets are so named since they force a physique into a starvation-like state called ketosis, in that a liver translates fats into molecules called ketones that disseminate in a blood and can offer as mitochondrial appetite sources for certain tissues. Ketogenic diets, therefore, shorten a volume of glucose accessible to cancer cells and force them to rest some-more heavily on oxidative metabolic pathways that competence selectively satisfy oxidative highlight in cancer cells.
“We’re meddlesome in a ketogenic diet for cancer therapy since it boundary glucose metabolism and emphasizes oxidative metabolism of greasy acids, ketone bodies, and amino acids in mitochondria. We consider that mitochondria from growth cells furnish some-more superoxide and hydrogen peroxide [two forms of reactive oxygen species] than mitochondria from normal cells,” pronounced Dr. Spitz. “Consuming a ketogenic diet should therefore selectively raise a attraction of growth cells to treatments that boost oxidative stress, such as deviation and chemotherapy.”
Radiation therapy is suspicion to kill cancer cells by generating giveaway radicals that means oxidative stress, and this can be extended by a coexisting use of chemotherapy (chemoradiation). “If oxidative highlight is selectively extended in cancer cells by a ketogenic diet, a reactive oxygen class constructed by a deviation and chemotherapy can some-more effectively repairs DNA, proteins, and other vicious biomolecules in a cancer dungeon and urge cancer dungeon killing, as good as improving healing outcome,” he explained.
In this proviso we clinical trial, patients with theatre III or IV (with singular metastasis) non-small dungeon lung cancer who are about to bear chemoradiation therapy will devour a ketogenic diet for a generation of their treatment. Doctors will consider a reserve and tolerability of a diet in and with chemoradiation treatment, as good as magnitude a levels of glucose and ketones in a blood and oxidative highlight markers in plasma and urine.
About 90 percent of calories in a ketogenic diet used in this investigate come from fat, since reduction than 2 percent of calories come from carbohydrates, with protein provision a remaining calories. Participants will devour specifically formulated shakes in a morning and work with a dietician to say a identical calorie change via a day. They will start a ketogenic diet 48 hours before a arising of chemoradiation therapy and continue by a finish of a 6- to 7-week diagnosis period.
“An glorious instance of a purpose of increasing glucose metabolism in cancer is a FDG-PET scan,” pronounced Dr. Bhatia. “We use PET scans with all of a lung cancer patients as partial of a evidence and entertainment tests. At a elemental level, a PET indicate is finished regulating glucose with a hot tab (18F-FDG) injected into a patient, and that glucose lights adult a area of growth cells since of their metabolic pathway. That’s how we establish where a growth is and, in metastatic disease, where a cancer has spread. With this diet, we wish to dispossess a growth of a glucose it depends on for appetite as good as raise oxidative stress.”
This study, as good as a identical investigate for pancreatic cancer patients, is being conducted during a University of Iowa’s Holden Comprehensive Cancer Center.
For More Information
See a lists of eligibility criteria and hearing hit information or call a NCI’s Cancer Information Service during 1-800-4-CANCER (1-800-422-6237). The toll-free call is confidential.