Ketogenic Metabolic Therapy, Without Chemo or Radiation, for the Long-Term Management of IDH1 -Mutant Glioblastoma: An 80-Month Follow-Up Case Report.
Level 4 - case-series / case-control
Single-patient case report
PubMed 34136522 · doi:10.3389/fnut.2021.682243
What was done
A 32-year-old male with an IDH1-mutant glioblastoma (WHO Grade 4, unmethylated MGMT promoter) refused standard chemotherapy, radiotherapy, and steroids after diagnosis in 2014. He self-administered a low-carbohydrate ketogenic diet high in saturated fats and meats, tracking his Glucose Ketone Index (GKI) to maintain values near 2.0 without weight loss. In 2017, he underwent surgical debulking and continued the ketogenic diet postoperatively.
What was found
The tumor grew slowly without expected vasogenic edema prior to surgical excision in 2017. Following surgery and continued ketogenic diet adherence, the patient remained alive at an 80-month follow-up (May 2021) with reported good quality of life and occasional seizures, though MRI continued to demonstrate slow interval tumor progression.
Why it matters
This report describes long-term survival in a single patient with IDH1-mutant glioblastoma treated with surgical debulking and ketogenic metabolic therapy alone, suggesting a possible area for clinical investigation into metabolic interventions in glioma management.
Limits
Findings represent a single individual (n=1), precluding any determination of causality or generalizability. The patient had an IDH1 mutation, which independently confers a more favorable prognosis compared to wild-type glioblastoma, confounding whether survival was driven by biology, surgical resection, the dietary intervention, or an interaction between them. Diet adherence and GKI monitoring were self-administered.
Cited by
- context Pablo Kelly lived for 10 years with an inoperable glioblastoma treated only with metabolic therapy, and died of a surgical hemorrhage rather than the tumor.