Pre-Ketone Supplements Linked to Better Outcomes in Prostate Cancer Treatment

About 13% of cisgender men worldwide will receive a diagnosis of prostate cancer during their lifetime, making it the second most diagnosed cancer globally. Even though the screening and early detection methods have improved, advanced stages of prostate cancer can be difficult to treat.  

A new study published in Cancer Research found that adding a component of the keto diet called a pre-ketone supplement may help a newer type of prostate cancer treatment called immunotherapy be more efficient in treating the cancer, via a mouse model. Immunotherapy is a treatment that uses the body’s immune system to fight cancer. 

There are currently two types of immunotherapies available for prostate cancer; cancer vaccines and immune checkpoint inhibitors. Immunotherapy through inhibiting T-cell immune checkpoint pathways PD1 or CTLA4 has revolutionized many therapies for other cancer types too. Advanced prostate cancer remains resistant to it due to an increase of pro-tumour immune cells coupled with insufficient tumour-specific antigens that the immune system can recognize to kill the cancer cells. 

Researchers analyzed the happenings of a pre-ketone supplement to immunotherapy for prostate cancer. Some of them tried ketogenic and pre-ketone BHB-generated supplements with the latter being potentially more practical for a patient to use in a clinic. Another reason to use a pre-ketone supplement is to determine if the presence of BHB was sufficient to enhance immunotherapy in the mouse models. 

With pre-ketone supplements showing an even better response in the current study, researchers conclude that the presence of BHB, rather than extremely low carbohydrate, was the key factor to drive better response to immunotherapy. 

Participants in groups received immunotherapy, a keto diet, or a pre-ketone supplement. Two more groups were given a combination of the keto diet and immunotherapy or the pre-ketone supplement plus immunotherapy. The sixth group was the control group. 

At the study’s conclusion, the researchers found there was no change in tumours in the immunotherapy-only group. Both the pre-ketone-supplement-only approach and the combination of keto diet and immunotherapy reduced cancer tumours and extended the lives of the mice. 

Overall, the scientists found that the group with the combination of pre-ketone supplement and immunotherapy had the best outcomes, with 23% of the mice becoming tumor-free. 

The pre-ketone supplement does two things to enhance immunotherapy;  make cancer cells more detectable to the immune system by increasing the presentation of molecular features on the surface of cancer cells or ketone body from the supplement, together with the immunotherapy, elicit special metabolic and molecular effects on immune cells so the cells are doubly stimulated to attack the cancer, potentially clearing it. The 23% cure rate certainly brought a lot of hope at this preclinical stage, because patients with castration-resistant prostate cancer have no curative treatment in the clinic.