İyikesici · Cureus 2021 · single-patient case report · n=1

Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response.

Level 4 - case-series / case-control

Single clinical case report

PubMed 33927959 · doi:10.7759/cureus.14686 · record verified 2026-08-26

What was done

A 47-year-old premenopausal female with stage IV (T4N3M1, ER+/PR+/HER2-) invasive ductal breast cancer, poor performance status (ECOG 3), and widespread metastases (brain, lungs, mediastinum, liver, abdomen, and bones) was treated at a specialized center. She underwent a six-month multimodal regimen consisting of metabolically supported chemotherapy (MSCT), a ketogenic diet (KD), hyperthermia (HT), and hyperbaric oxygen therapy (HBOT), followed by maintenance therapy with KD, dietary supplements, and repurposed medications.

What was found

Following the six-month multimodal protocol, post-treatment imaging (contrast-enhanced brain MRI and whole-body 18F-FDG PET-CT) showed complete elimination of all detectable metastatic lesions. The complete response was maintained for two years during ongoing maintenance therapy.

Why it matters

This report describes a complete radiographic response in a patient with widely metastatic breast cancer using metabolic adjuncts alongside chemotherapy, generating a hypothesis for metabolic targeting strategies in refractory advanced malignancy.

Limits

This is an uncontrolled single-patient case report (n=1), meaning findings cannot establish efficacy or be generalized to other patients. The simultaneous administration of multiple interventions (chemotherapy, ketogenic diet, hyperthermia, hyperbaric oxygen, repurposed drugs, and supplements) makes it impossible to determine the contribution or necessity of any individual component. Case reports are subject to severe publication bias.

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