Evidence map›Paper›PMID 42077003›Full record

ReviewNutrition and cancer2026

How the Ketogenic Diet Shapes the Microbiome to Influence Cancer Immunotherapy Outcomes: An Exploration of Clinical Trials and Their Results.

Jonah Bukovac, Marium Husain, Teryn Sapper, Angela O'Dell, Marisa Bittoni, Helena Gastier, Ashwini Chebbi, Victoria Hockenhull, Zachary Dohar, Jennifer Moon and 7 more

Abstract readReview
In one paragraph

Review in Nutrition and cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Jonah BukovacPelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.ORCID 0009-0009-0970-4825
Marium HusainDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Teryn SapperDepartment of Human Sciences, The Ohio State University, Columbus, OH, USA.
Angela O'DellComprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Marisa BittoniDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Helena GastierComprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Ashwini ChebbiDepartment of Human Sciences, The Ohio State University, Columbus, OH, USA.
Victoria HockenhullComprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Zachary DoharComprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Jennifer MoonComprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Fred TabungDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.ORCID 0000-0001-8193-7150
Claire VerschraegenDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Richard WuDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Kari KendraDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Yuanquan YangDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Jeff VolekDepartment of Human Sciences, The Ohio State University, Columbus, OH, USA.
Daniel SpakowiczPelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.ORCID 0000-0003-2314-6435

Funding

Translational Therapeutics Research Program (TT)P30CA016058 · NCI · OHIO STATE UNIVERSITY · PI Daniel G. Stover · 1985 to 2026
$132.3M
Targeting immunosuppressive adenosine in patients with metastatic non-small cell lung cancerR01CA248741 · NCI · OHIO STATE UNIVERSITY · PI CARBONE, DAVID P., DIKOV, MIKHAIL M · 2021 to 2025
$3.0M
BIO-ORGANIC MECHANISMS OF PEPTIDE ANTIBIOTICSR01AI046611 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI MCCAFFERTY, DEWEY G · 2000 to 2009
$2.7M
The microbiome in older adults with lung cancer: association of treatment regimens and diet with protective microbial profilesK01AG070310 · NIA · OHIO STATE UNIVERSITY · PI SPAKOWICZ, DANIEL J. · 2021 to 2025
$583k
Role of the inflammatory dietary pattern in gut and colon tissue microbiomes and impact on survival outcomes among colorectal cancer patientsR21CA294050 · NCI · OHIO STATE UNIVERSITY · PI TABUNG, FRED KINYUY · 2024 to 2024
$405k
NCI NIH HHS P30 CA016058NCI NIH HHS R01 CA248741NCI NIH HHS R21 CA294050NIAID NIH HHS R01 AI046611NIA NIH HHS K01 AG070310
6 · The paper itself

Abstract

Ketogenic dietary interventions (KDIs) are increasingly explored as adjuncts in oncology due to their metabolic and immunomodulatory effects. One mechanism by which KDIs are expected to modulate the immune system is by altering the gut microbiome, which has been shown to affect treatment outcomes, particularly in the context of immunotherapies. This review synthesized findings from 43 clinical trials to evaluate the current landscape of KDIs in cancer care, with a focus on the gut microbiota and immunotherapy. Although 47% of identified trials are completed, none have yet published results combining KDIs with immunotherapy. Since 2020, however, there has been a significant increase in ongoing studies investigating this combination and incorporating microbiome endpoints. While KDIs may help shape an immunotherapy-permissive environment, further clinical evaluation is necessary to determine the full extent of KDIs on the microbiome. Future research should prioritize longitudinal microbiome profiling and standardized adherence reporting to clarify the therapeutic potential of KDIs as a metabolic adjuvant to immune checkpoint inhibitors.

Indexed as

Diet, KetogenicGastrointestinal MicrobiomeImmunotherapyNeoplasmsClinical Trials as TopicHumansTreatment Outcome

Identifiers

PMID42077003
PMCPMC13247657

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.