Beta-hydroxybutyrate, a ketogenic dietary supplement, for patients with large B-cell lymphomas receiving CAR-T

When large B-cell lymphoma comes back after initial treatment, it is very difficult to cure. For patients in this situation, CAR-T immunotherapy is a standard treatment. CAR-T is a novel type of cancer treatment that re-educates patients' immune cells to recognize and kill tumor cells. Unfortunately, CAR-T often fails because patients’ immune cells are not healthy enough to attack their cancer. We discovered that a dietary supplement improves the ability of CAR T cells to kill cancer. When we tested this dietary supplement in laboratory experiments, we found that the supplement helped the CAR T cells to kill the cancer better than CAR T cells alone. We also studied this supplement’s effects in healthy people, and we found that it also improved their immune system function. Our main goals are now to show that this new dietary supplement together with CAR-T is safe for patients with lymphoma, improves CAR T cell function, and increases the number of patients who are cured. In this project, we will undertake a clinical trial to study the effects of this supplement on CAR T cells and patients’ immune systems. Patients with large B-cell non-Hodgkin lymphomas who are undergoing treatment with CAR T cells will be invited to participate. In addition to CAR T cells, patients will take a small amount of a dietary supplement prior to and after receiving CAR T cells. We will study whether patients receiving CAR T cells are able to successfully take the dietary supplement, and whether they have any side effects from this approach. We will also how well CAR T cells plus the dietary supplement treats patients’ lymphoma. Finally, we will study changes in patients’ blood, stool, and tumors to examine the effects of the dietary supplement on patients' immune system and GI tract health. This study has the potential to change the outlook for people with large B-cell lymphoma that has come back or is not responding to treatment. This study will provide patients with an easily implemented, innovative dietary approach to improve the standard therapies already in use to fight lymphomas. We expect this approach will be both non-toxic as well as broadly applicable to many other types of cancer. It may also be applied to enhance other therapies that use T cells to attack cancer.