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

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.