In newly diagnosed glioblastoma, ketogenic metabolic therapy pushed 3-year survival to 27%, up from 7% in contemporary controls. Median overall survival rose to 21.5 months from 14.7 months. The hazard ratio for overall survival was 0.42, with mild to moderate adverse events and better exercise activity and quality of life.
Published June 29, 2026 in Neuro-Oncology Advances, the trial focused on newly diagnosed IDH-wildtype glioblastoma patients and tested an intensive multimodal program layered onto standard care. That meant chemoradiation and adjuvant chemotherapy were paired with prolonged fasting, time-restricted feeding, and a ketogenic diet, with the glucose ketone index, or GKI, used as the main biomarker to track adherence and metabolic response.
Among 32 eligible patients, 18 started the intervention and 15 completed it. Fifteen of the 18, or 83%, sustained a mean daily GKI of 6 or lower during chemoradiation. In the per-protocol group, GKI averaged 1.88 during chemoradiation and 2.53 throughout chemotherapy.
Standard therapy still produces a median overall survival of about 11 to 14 months, and survival has not improved substantially since the Stupp protocol became standard of care in 2005. Recurrence is almost universal, and fewer than 5% of patients survive beyond 3 years under standard treatment.
The intervention was tightly monitored, medically supervised, and designed as an adjunct to surgery, radiation, and temozolomide, not a replacement. In the trial, intentional weight loss averaged 17%, body-mass index normalized, and the metabolic therapy-related side effects were mild or moderate.
An earlier Cedars-Sinai phase 1 trial used a 16-week ketogenic diet with standard radiation and temozolomide, enrolled 21 patients, and tracked safety, nutrition, quality of life, and tumor assessments.
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