Ketogenic Diet in Combination With Standard-of-care Radiation and Temozolomide for Patients With Glioblastoma

Exclusion Criteria

• •Karnofsky Performance Status of \<70 as deemed by physician or equivalent
• •Body Mass Index of \<22 kg/m2 (rounded to nearest integer)
• •Patients with disorders that affect lipid metabolism such as pyruvate carboxylase deficiency, porphyria, primary carnitine deficiency, carnitine palmitoyltransferase I or II deficiency, carnitine translocase deficiency, Beta-Oxidation Defects
• •Medical comorbidities that in the opinion of the investigator limits the patient's ability to complete this study
• •Pregnant, nursing, or implanted with an intrauterine device (IUD) that is not MR compatible
• •Patients who are vegan or vegetarian will be excluded, as the ketogenic diet includes foods that may interfere with these preferences
• •Patients on high doses of steroids will be excluded
• •Patients currently receiving experimental therapeutic therapy will be excluded from the trial. Note: Off-label therapy use is permitted
• •Inability to adhere to the protocol
• •Patients with history of allergic reactions to surgical steel or elastomer/rubber are excluded from the activity monitor portion of the study. Because the activity monitor uses a Bluetooth low energy Transceiver, individuals using pacemakers, implantable cardiac defibrillators, neuro-stimulation devices, cochlear implants, hearing aids, or other electronic medical equipment should also be excluded from wearing the activity monitor. They can still use the Aria scale to record weight.
• •Patients with mechanically, magnetically, or electrically activated implants, such as cardiac pacemakers, neurostimulators, and infusion pumps, that are not magnetic resonance imaging/positron emission tomography (MRI/PET) compatible.
• •Patients with ferromagnetic implants and ferromagnetic foreign bodies, such as intracranial, aneurysm clips, shrapnel and intraocular metal chips as these could become dislodged.
• •Patients unable to tolerate MRI/PET imaging secondary to an inability to lie supine or severe claustrophobia as assessed by the treating physician or principal investigator.
• •Patients unable to lie still, hold their breath, or follow imaging procedure instructions as assessed by the treating physician or PI.
• •Patients whose most recent renal function test does not meet Cedars-Sinai Medical center standard of care MRI contrast protocol requirements (glomerular filtration rate \<45ml/min).
• •Patients with a known allergy to Fludeoxyglucose F18 (F18-FDG) radioactive tracer or gadolinium-based contrast agent.
• •Patients with allergy to animal dander or animal-instigated asthma.