Short-term fasting in glioma patients: analysis of diet diaries and metabolic parameters of the ERGO2 trial

  • Purpose: The prospective, randomized ERGO2 trial investigated the effect of calorie-restricted ketogenic diet and intermittent fasting (KD-IF) on re-irradiation for recurrent brain tumors. The study did not meet its primary endpoint of improved progression-free survival in comparison to standard diet (SD). We here report the results of the quality of life/neurocognition and a detailed analysis of the diet diaries. Methods: 50 patients were randomized 1:1 to re-irradiation combined with either SD or KD-IF. The KD-IF schedule included 3 days of ketogenic diet (KD: 21–23 kcal/kg/d, carbohydrate intake limited to 50 g/d), followed by 3 days of fasting and again 3 days of KD. Follow-up included examination of cognition, quality of life and serum samples. Results: The 20 patients who completed KD-IF met the prespecified goals for calorie and carbohydrate restriction. Substantial decreases in leptin and insulin and an increase in uric acid were observed. The SD group, of note, had a lower calorie intake than expected (21 kcal/kg/d instead of 30 kcal/kg/d). Neither quality of life nor cognition were affected by the diet. Low glucose emerged as a significant prognostic parameter in a best responder analysis. Conclusion: The strict caloric goals of the ERGO2 trial were tolerated well by patients with recurrent brain cancer. The short diet schedule led to significant metabolic changes with low glucose emerging as a candidate marker of better prognosis. The unexpected lower calorie intake of the control group complicates the interpretation of the results. number: NCT01754350; Registration: 21.12.2012.
Author:Martin VoßORCiDGND, Katharina Johanna Wenger-AlakmehORCiDGND, Nina von Mettenheim, Jörg BojungaGND, Manuela Vetter, Bianca Diehl, Kea Franz, Rüdiger Gerlach, Michael Wilfried RonellenfitschORCiDGND, Patrick Nikolaus HarterORCiDGND, Elke HattingenORCiDGND, Joachim Peter SteinbachORCiDGND, Claus RödelORCiDGND, Johannes RiegerGND
Parent Title (English):European journal of nutrition
Place of publication:Darmstadt
Document Type:Article
Date of Publication (online):2021/09/06
Date of first Publication:2021/09/06
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/04/19
Tag:Fasting; Glioblastoma; Glucose; Ketogenic diet; Leptin; Radiation
Issue:online version before inclusion in an issue
Page Number:11
Open Access funding enabled and organized by Projekt DEAL. The Senckenberg Institute of Neurooncology is supported by the Senckenberg Foundation. This trial was funded by the investigator-initiated trial (IIT) program of the University Cancer Center Frankfurt (UCT). Ketogenic drinks were supplied by Tavarlin® without costs. Neither the UCT nor Tavarlin® had any involvement in the clinical trial itself or the writing of the report.
Version of Record:
Early View: Online Version before inclusion in an issue.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0