RESEARCH ARTICLE

Impact of Slow- Infusion (Metronomic) 2-Deoxy-D-Glucose in Treatment of Refractory Patient of Gliobalstoma Multiforme

Mandeep Singh.1,2 Roshika Tiwari.1 Sonal Jain.1 Daniel Stanciu.4 Metin Kurtoglu.3 Arpan Talwar.1 Theodore J Lampidis.3 

• .1Art of Healing Cancer (AOHC), Oncology 
• .2CK Birla Hospital, New Delhi 
• .3University of Miami, Miller School of Medicine, Cell Biology 
• .4Cancer Research Treatments, Cancer Research Foundation

Corresponding Author: Mandeep Singh, Art of Healing Cancer (AOHC), Oncology, New Delhi, India. E-mail: [email protected], [email protected] 

Received: July 17, 2023                                                   Published: July 30, 2023 

Citation: Mandeep S. Impact of Slow- Infusion (Metronomic) 2-Deoxy-D-Glucose in Treatment of Refractory Patient of Gliobalstoma Multiforme. Int J Complement Intern Med. 2023;5(1):198–202. DOI: 10. 58349/IJCIM. 1. 5. 2023. 00131 

Copyright: ©2023 Singh. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially.

Abstract 

Glucose, an energy source for cells, also forms the backbone for the creation of ribose and deoxyribose, vital for RNA and DNA synthesis, and is key to the development of necessary lipids and specific amino acids for cell growth. It has been observed that amount of glucose usage corresponds with heightened malignancy, poor prognosis, and increased treatment resistance in cancer cells. It has been observed that modulation of glucose flux and energy supply to tumor cells leads to better cancer control. An innovative method to is the use of 2-deoxy-D-glucose (2-DG), it’s a glucose molecule which has the 2-hydroxyl group replaced by hydrogen. It enters tumor cells preferentially through the same glucose transporters. Once inside, it gets phosphorylated by hexokinase to become 2-deoxy-d-glucose-6-phosphate (2-DG-6-P) which halts further glucose metabolism. This disruption severely depletes ATP in hypoxic tumor cells relying on glycolysis for energy, causing cell death. In areas with ample oxygen where fats and proteins serve as energy substitutes, ATP depletion is less acute, yet 2- DG administration curtails protein translation, hindering proteins vital for cell growth and duplication. 2-DG, also acting as a mannose mimetic, disrupts N-linked glycosylation and induces endoplasmic reticulum (ER) stress, which has shown to inhibit tumor cells' growth. Infusing 2-DG at low doses or metronomically is suggested to enhance cancer control. This case study shows substantial improvements in both radiological outcomes and clinical parameters in a Glioblastoma Multiforme; Grade IV patient by incorporating low dose metronomic 2-DG infusion into the treatment. The patient had undergone surgery followed by radiation and was on Temozolomide therapy. 2-DG disrupts cancer cells' energy metabolism significantly, making them more susceptible to cytotoxic drugs like doxorubicin, cisplatin, and gemcitabine, enhancing radiotherapy effects, particularly in Glioblastoma Multiforme.Malignant gliomas, some of the most resistant tumors, are incredibly heterogeneous with multiple hypoxic regions. 2-DG, due to its ability to penetrate the blood-brain barrier (BBB) and starve hypoxic cancer cells, holds significant potential in glioma treatments.

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