On World Kidney Cancer Day, we examine the evidence for TCR as a supportive therapy in this condition.
Current evidence generally demonstrates mixed outcomes in preclinical studies, dependent on tumour models, genetics, diet composition, and adjunctive pharmacotherapy (1-3).
The core rationale for ketogenic therapies in cancer is the metabolic vulnerability of many cancer types, whereby tumours switch to energy production via glycolysis rather than oxidative phosphorylation. Ketogenic diets disrupt cancer cell metabolism by reducing the preferred fuel source, glucose. This vulnerability has been confirmed in renal carcinogenesis (2).
A feasibility and safety study published this month examined the use of a ketogenic diet (KD) combined with systemic therapy in 21 adult patients. Participants followed a 2:1 KD with medium-chain triglyceride supplementation, ketone body monitoring, and dietitian-led support. Eight participants completed 12 months of KD therapy. The authors concluded that the KD was feasible and had an acceptable safety profile, but no conclusions regarding tumour response could be drawn (mixed responses). Long-term adherence in this group was challenging (4).
An interesting case study from last year presented findings from a 65-year-old woman with clear cell renal carcinoma (surgically managed) and brain metastases, placed on ketogenic metabolic therapy along with other therapies. The patient maintained a consistent partial response to the metastatic clear cell carcinoma over the 15 months of follow-up reported (5).
Overall, the KD for kidney cancer remains experimental in human subjects with no clear anti-tumour benefit and mixed outcomes among preclinical models. Broader clinical trials examining other tumour types suggest metabolic and quality of life improvements, which may be considered on a case-by-case basis.
- Benoit, M., et al. “EFFECT OF A KETOGENIC DIET ON THE CLEAR CELL RENAL CELL CARCINOMA CELL GROWTH: MP72‐13.” The Journal of Urology, vol. 199, 2018, pp. e957, https://doi.org/10.1016/j.juro.2018.02.2297.
- Richard, J et al. “Ketogenic diet enhances the anti-cancer effects of PD-L1 blockade in renal cell carcinoma.” Frontiers in Endocrinology, vol. 15, 2024, https://doi.org/10.3389/fendo.2024.1344891.
- Vidali, S et al. “The ketogenic diet is not feasible as a therapy in a CD-1 nu/nu mouse model of renal cell carcinoma with features of Stauffer’s syndrome.” Oncotarget, vol. 8, 2017, pp. 57201 – 57215, https://doi.org/10.18632/oncotarget.19306.
- Rolley, C. et al. (2026) ‘Feasibility and Safety of a Ketogenic Diet During Systemic Therapy for Metastatic Renal Cell Carcinoma: Results from the Cetorein Pilot Study’, Nutrients, 18(11), p. 1712. Available at: https://doi.org/10.3390/nu18111712.
- Acevedo, A. and Zapata Laguado, M. (2025) ‘Clear Cell Renal Cell Carcinoma With Brain Metastases Treated With Complementary Ketogenic Metabolic Therapy: A Case Report’, Cureus, 17(5), p. e84962. Available at: https://doi.org/10.7759/cureus.84962.