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

Matthias Kraft1, Kathleen Kraft1, Simone Gärtner1, Julia Mayerle1, Peter Simon1, Eckhard Weber1, Kerstin Schütte2, Jens Stieler3, Heide Koula-Jenik4, Peter Holzhauer4, Uwe Gröber5, Georg Engel6, Cornelia Müller7, You-Shan Feng9, Ali Aghdassi1, Claudia Nitsche1, Peter Malfertheiner2, Maciej Patrzyk8, Thomas Kohlmann9 and Markus M Lerch1*

Author affiliations

1 Department of Medicine A, University Medicine Greifswald, Friedrich Löffler Straße 23a, Greifswald, 17475, Germany

2 Department for Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University Magdeburg, Magdeburg, Germany

3 Charité Universitaetsmedizin Berlin, Campus Virchow-Clinic, Medical Clinic Hematology/Oncology, Berlin, Germany

4 Veramed Clinic, Brannenburg, Germany

5 Academy of Micronutrient Medicine, Essen, Germany

6 University Pharmacy, University Medicine Greifswald, Greifswald, Germany

7 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany

8 Department of Surgery, University Medicine Greifswald, Greifswald, Germany

9 Institute of Community Medicine, University Medicine of Greifswald, Greifswald, Germany

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Citation and License

Nutrition Journal 2012, 11:52  doi:10.1186/1475-2891-11-52

Published: 23 July 2012

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.

Keywords:
Pancreatic adenocarcinoma; L-Carnitine; Quality of life; Survival; Cancer cachexia; Fatique syndrome