Ketone Boost Enhances Immunotherapy, Human Trials Begin

A naturally occurring metabolite can strengthen CAR T cells to improve tumor control across multiple cancer models.

Published on Mar. 7, 2026

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Researchers have found that the ketone body β-hydroxybutyrate (BHB), a byproduct of liver metabolism, can enhance the fitness and antitumor activity of CAR T cells used in cancer immunotherapy. The team demonstrated that BHB can act as a powerful fuel source for T cells, reshaping their energy production and gene regulation in ways that improve tumor control across multiple cancer models, including lymphoma, leukemia, and pancreatic cancer. A clinical trial of BHB supplementation in large B-cell lymphoma is already underway, suggesting a future where metabolic approaches could offer an accessible strategy to improve T cell function and cancer treatment.

Why it matters

CAR T cell therapy has revolutionized treatment for certain blood cancers, but many patients still fail to respond or eventually relapse. This challenge has led scientists to search for new, practical ways to strengthen T cell metabolism without presenting additional burdens on patients. The discovery that a naturally occurring metabolite like BHB can enhance CAR T cell efficacy opens up the potential for low-cost, scalable, and easily integrated metabolic interventions to advance cancer treatment.

The details

The research team, led by Maayan Levy of Stanford University and the Arc Institute, found that a ketogenic diet consistently improved tumor control following CAR T therapy in mice, and that this effect was due to higher levels of BHB in the ketogenic-fed mice. Further testing showed that BHB supplementation alone could provide the same benefits, improving CAR T cell expansion and tumor killing across several cancer models. Mechanistically, the researchers found that BHB helps CAR T cells rapidly incorporate it into the TCA cycle, the central pathway that powers mitochondria, creating more usable energy and allowing the cells to better withstand the stress of fighting cancer. BHB-treated CAR T cells also expressed more genes associated with activation and tumor killing, and fewer associated with exhaustion.

  • The findings were reported on March 6, 2026 in the journal Cell.
  • A clinical trial of BHB supplementation in Large B-cell Lymphoma is already underway.

The players

Maayan Levy

An Assistant Professor of Pathology at Stanford University and an Arc Innovation Investigator in Residence, who led the research team.

Arc Institute

A research institute that collaborated with Stanford University and the University of Pennsylvania on this study.

Stanford University

A research institution that collaborated with the Arc Institute and the University of Pennsylvania on this study.

University of Pennsylvania

A research institution that collaborated with the Arc Institute and Stanford University on this study.

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What they’re saying

“CAR T cell therapy has revolutionized treatment for certain blood cancers, yet many patients still fail to respond or eventually relapse. This challenge has led scientists to search for new, practical ways to strengthen T cell metabolism, without presenting additional burdens on patients.”

— Maayan Levy, Assistant Professor of Pathology at Stanford and Arc Innovation Investigator in Residence (Cell)

“Importantly, these improvements were seen only in the presence of CAR T cells––BHB alone had little or no impact in mice treated with non-engineered T cells. This shows that BHB improves CAR T efficacy by enhancing immune function rather than acting directly on tumors.”

— Maayan Levy, Assistant Professor of Pathology at Stanford and Arc Innovation Investigator in Residence (Cell)

What’s next

A clinical trial of BHB supplementation in Large B-cell Lymphoma is already underway, suggesting a future in which metabolic supplementation could offer a safe, inexpensive, and accessible strategy to improve T cell function and advance cancer treatment and care.

The takeaway

This study highlights the untapped potential of metabolic and lifestyle approaches to enhance cancer immunotherapies. By providing CAR T cells with an efficient, naturally occurring fuel source like BHB, researchers have found a way to meaningfully improve the performance of these therapies, even in cancers where current treatments have struggled.