In the laboratories of the University of Pennsylvania, a group of researchers found in the ketogenic diet — popularly known as keto — a possible ally to improve the effectiveness of a cutting-edge treatment against certain types of cancer.
The finding emerged from a study conducted by the Perelman School of Medicine and the Abramson Cancer Center at Penn Medicine, which evaluated how different eating habits could influence the effectiveness of CAR T-cell therapy, a procedure that modifies immune system cells to attack malignant tumors.
CAR T cells have represented a major advance in the treatment of blood cancers, although not all patients respond equally. Faced with this challenge, the research team decided to try a different approach: intervening in the diet rather than further modifying the cells.
“We sought to target T cells through nutrition, not just genetic engineering,” explained Shan Lui, co-senior author of the study.
The experiments began in mice with rapidly growing tumors, which were given diets with different proportions of fiber, cholesterol, protein, and fat.
The key: beta-hydroxybutyrate
The results were surprising. The keto-fed animals showed not only better tumor control but also increased survival. Their analysis revealed an increase in beta-hydroxybutyrate, a metabolite produced by the liver in response to ketosis.
“CAR T cells appear to prefer beta-hydroxybutyrate as an energy source over glucose,” said Puneeth Guruprasad, co-director of the study. “This gives them a greater ability to kill cancer cells.”
Based on this hypothesis, the scientists added beta-hydroxybutyrate supplements to treated rodents, even while maintaining a standard diet. The effect was clear: more activated CAR T cells and, in many cases, cancer disappearance.
Human evidence and clinical trials
When the analysis was translated to patients, it was found that those with higher levels of beta-hydroxybutyrate responded better to CAR T-cell therapy. This approach is currently being evaluated in a Phase I clinical trial at the Abramson Cancer Center.
“It’s a low-cost intervention with low potential for toxicity,” emphasized Dr. Maayan Levy, co-author of the project.
What is the ketogenic diet and its risks?
The keto diet, now a global trend, is characterized by a high fat intake—up to 90% of daily calories, according to Harvard—while minimizing carbohydrates and sugars.
In medicine, it has been used primarily to control seizures in children with epilepsy. However, prolonged use carries risks, such as increased LDL cholesterol and a greater risk of cardiovascular disease.
Hence, specialists warn that any such regimen should be done under medical supervision.
Although the findings open the door to new ways to enhance cancer treatments, experts agree that further studies are still needed to confirm the effectiveness and safety of this strategy.
