Abstract
BackgroundCachexia, 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.FindingsWe 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.).ConclusionWhile 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.
Highlights
Cachexia, a >10% loss of body-weight, is one factor determining the poor prognosis of pancreatic cancer
There was no statistically significant difference between both groups (p < 0,05). 90% of the patients reported a weight loss of >10% during the previous 6 month. This observation is in line with previous reports on cancer cachexia [5]. 26 patients completed the entire follow up period and premature drop-out was due to death (n = 11), deteriorating health (n = 9), nausea (n = 8), excessive demand (n = 5), diarrhea (n = 2) or miscellaneous symptoms (n = 7)
L-Carnitine is critical for energy generation by mitochondrial ßoxidation and was found depleted under chemotherapy [24,25,26]
Summary
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. One reason contributing to this high mortality is cancer cachexia, defined as an unintended weight loss of more than 10% in 6 months, which is present in more than 80% of pancreatic cancer patients [5]. A deficiency of L-Carnitine has been proposed to be an underlying cause of cancer cachexia [11] and tumor associated fatigue [12,13,14]. L-Carnitine is well known for its potential to modulate the inflammatory response mechanisms, which is known to play the predominant role in the generation of cancer cachexia, especially in pancreatic tumor patients [16]. We conducted a multicentre trial to investigate the role of oral L-Carnitine supplementation on cancer cachexia in pancreatic cancer (CARPAN)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
