Evidence map›Paper›PMID 24728273›Full record

Trial reportInternational journal of oncology2014

ERGO: a pilot study of ketogenic diet in recurrent glioblastoma.

Johannes Rieger, Oliver Bähr, Gabriele D Maurer, Elke Hattingen, Kea Franz, Daniel Brucker, Stefan Walenta, Ulrike Kämmerer, Johannes F Coy, Michael Weller and 1 more

Erratum issued Registry-linked trialOpen access · hybridAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT00575146 (Ketogenic Diet for Patients With Recurrent Glioblastoma), which is not on this map. Cited by 160 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
160citing papers in PubMed, 18 pooled it
11.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00575146 phase1completednot on this map

Ketogenic Diet for Patients With Recurrent Glioblastoma

TypeinterventionalSponsorUniversity Hospital TuebingenRan2007 to 2010Enrolled20ConditionsRecurrent GlioblastomaArmsTAVARLIN
3 · Its place in the literature

Who cites it

160 citing papers in PubMed, 18 syntheses or guidelines pooled it, 272 citations in OpenAlex.

  1. Pooled it
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  3. Efficacy and safety of ketogenic diet in glioblastoma: an updated systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
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  8. Guideline
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  17. Systematic review: isocaloric ketogenic dietary regimes for cancer patients.Medical oncology (Northwood, London, England) · 2017
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100 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

  • Erratum issued
5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Johannes RiegerDr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, D-60528 Frankfurt, Germany.
Oliver BährDr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, D-60528 Frankfurt, Germany.
Gabriele D MaurerDr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, D-60528 Frankfurt, Germany.
Elke HattingenInstitute of Neuroradiology, University Hospital Frankfurt, D-60528 Frankfurt, Germany.
Kea FranzDepartment for Neurosurgery, University Hospital Frankfurt, D-60528 Frankfurt, Germany.
Daniel BruckerDr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, D-60528 Frankfurt, Germany.
Stefan WalentaInstitute of Physiology and Pathophysiology, Johannes Gutenberg-University, D-55099 Mainz, Germany.
Ulrike KämmererDepartment of Obstetrics and Gynecology, University Hospital of Würzburg, D-97080 Würzburg, Germany.
Johannes F CoyTavarlin AG, D-64293 Darmstadt, Germany.
Michael WellerDepartment of Neurology, University Hospital Tübingen, D-72076 Tübingen, Germany.
Joachim P SteinbachDr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, D-60528 Frankfurt, Germany.
University Hospital Frankfurt · DEGoethe University Frankfurt · DEJohannes Gutenberg University Mainz · DEUniversitätsklinikum Würzburg · DEUniversity Children's Hospital Tübingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Limiting dietary carbohydrates inhibits glioma growth in preclinical models. Therefore, the ERGO trial (NCT00575146) examined feasibility of a ketogenic diet in 20 patients with recurrent glioblastoma. Patients were put on a low-carbohydrate, ketogenic diet containing plant oils. Feasibility was the primary endpoint, secondary endpoints included the percentage of patients reaching urinary ketosis, progression-free survival (PFS) and overall survival. The effects of a ketogenic diet alone or in combination with bevacizumab was also explored in an orthotopic U87MG glioblastoma model in nude mice. Three patients (15%) discontinued the diet for poor tolerability. No serious adverse events attributed to the diet were observed. Urine ketosis was achieved at least once in 12 of 13 (92%) evaluable patients. One patient achieved a minor response and two patients had stable disease after 6 weeks. Median PFS of all patients was 5 (range, 3-13) weeks, median survival from enrollment was 32 weeks. The trial allowed to continue the diet beyond progression. Six of 7 (86%) patients treated with bevacizumab and diet experienced an objective response, and median PFS on bevacizumab was 20.1 (range, 12-124) weeks, for a PFS at 6 months of 43%. In the mouse glioma model, ketogenic diet alone had no effect on median survival, but increased that of bevacizumab-treated mice from 52 to 58 days (p<0.05). In conclusion, a ketogenic diet is feasible and safe but probably has no significant clinical activity when used as single agent in recurrent glioma. Further clinical trials are necessary to clarify whether calorie restriction or the combination with other therapeutic modalities, such as radiotherapy or anti-angiogenic treatments, could enhance the efficacy of the ketogenic diet.

Indexed as

AdultAgedAnimalsAntibodies, Monoclonal, HumanizedAntineoplastic AgentsBevacizumabCombined Modality TherapyDiet, KetogenicFemaleGlioblastomaHumansKetosisMaleMiceMice, NudeMiddle AgedAntibodies, Monoclonal, HumanizedAntineoplastic AgentsBevacizumab

Identifiers

PMID24728273
PMCPMC4063533
OpenAlexW2143786940

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.