L-Carnitine-supplementation in advanced pancreatic cancer (CARPAN)--a randomized multicentre trial

Abstract

Background: Cachexia, a >10% loss of body-weight, is one factor determining the poor prognosis of pancreatic cancer. Deficiency of L-Carnitine has been proposed to cause cancer cachexia.

Findings: We screened 152 and enrolled 72 patients suffering from advanced pancreatic cancer in a prospective, multi-centre, placebo-controlled, randomized and double-blinded trial to receive oral L-Carnitine (4 g) or placebo for 12 weeks. At entry patients reported a mean weight loss of 12 ± 2.5 (SEM) kg. During treatment body-mass-index increased by 3.4 ± 1.4% under L-Carnitine and decreased (-1.5 ± 1.4%) in controls (p < 0.05). Moreover, nutritional status (body cell mass, body fat) and quality-of-life parameters improved under L-Carnitine. There was a trend towards an increased overall survival in the L-Carnitine group (median 519 ± 50 d versus 399 ± 43 d, not significant) and towards a reduced hospital-stay (36 ± 4d versus 41 ± 9d,n.s.).

Conclusion: While these data are preliminary and need confirmation they indicate that patients with pancreatic cancer may have a clinically relevant benefit from the inexpensive and well tolerated oral supplementation of L-Carnitine.

Figure 1

Flow chart of the trial.

Figure 2

Reasons for discontinued convention of the study patients. Reasons for discontinued convention of the study patients.

Figure 3

Relevant nutritional parameters and survival. Relevant nutritional parameters (means ± SEM) and survival in days in the L-Carnitine treatment arm (black lines) and placebogroup (gray lines). Survival is given in days after diagnosis as Kaplan-Meier curve and body mass index (BMI), body fat, and body cell mass (BCM) aregiven as percent changes under respective treatment over 12 weeks. Asterisks indicate statistically significant differences (p < 0.05).