Ketogenic diet can enhance targeted cancer treatment

The low-carbohydrate and high-fat diet called ketogenic diet may improve the efficacy of an emerging class of carcinogenic drugs, according to a study conducted by Weill Cornell Medicine, Columbia University Irving Medical Center and the NewYork-Presbyterian.

This study was published in Nature journal on July 4, 2018, and scientists provide a possible explanation for why drugs targeting insulin-activated enzyme PI3K (phosphatidylinositol-3 kinase) whose mutations are involved in many cancers, and consequently have the ability to enhance the possibility of killing tumors during treatments.

“It is worth noting that even if the drug targets PI3K it may not be effective if patients can not maintain low blood sugar via diet or medication,” said lead investigator Dr. Lewis C. Cantley of Weill Cornell Medicine. “We have proven through our research that if we maintain insulin at desirable levels through the ketogenic diet, it has the power to dramatically improve the effectiveness of these anti-cancer drugs.”

Some of the most common genetic mutations observed in tumor tumors affect PI3K. Understanding the frequency of mutations in the gene has helped earlier research by other scientists to create anticancer drugs for more than 20 therapies that inhibit the PI3K enzyme, an attempt that has not been crowned with absolute success.

Until now, the results of past clinical trials have been disappointing. Some patients taking these medicines developed too high blood sugar or hyperglycemia. This phenomenon is considered temporary because the pancreas can usually compensate for it by producing more insulin. But some blood sugar levels in patients do not return to normal and should stop taking these medicines, since they no longer react effectively to the patient.

“In the study, Dr. Hopkins and colleagues demonstrated that elevation of insulin levels reactivates PI3K in mice with pancreatic tumors treated with a PI3K inhibitor called Buparlisib. But reactivation of PI3K in the tumor alone does not make the drug relatively effective, “Dr. Cantley from Weill Cornell Medicine.

This observation has led researchers to reach the tools and methodologies of the endocrinologist for treatments that help fight blood sugar and insulin levels. Together with PI3K inhibitors, they were treated with metformin drugs or sodium-glucose co-transporter 2 (SGLT2) – or with the ketogenic diet.

The most important element of all is that the keto diet, which has been used in clinical trials for about four decades to control insulin levels, has proven to be the best job of preventing glucose and insulin, also helping to reduce the growth of cancerous tumors.

Dr. Hopkins said: “The ketogenic diet proved to be the perfect approach since it reduced glycogen stores so that mice can not release glucose in response to inhibition of PI3K. This means that if you can block the rise of blood glucose in conjunction with subsequent insulin feedback, you can make medicines much more effective in controlling tumor growth.

“This study represents a genuinely innovative approach to cancer, for decades we have been trying to change human metabolism to make cancer cells more susceptible to chemotherapy or targeted drugs. in animal models. The findings of the study are a great surprise to us and to the scientific community, “Dr. Siddhartha Mukherjee from Columbia University Irving Medical Center.