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

Multicenter, randomized, double-blind, placebo-controlled trial in adults with histologically confirmed advanced unresectable pancreatic adenocarcinoma (UICC Stage IV) and Karnofsky >60; 72 participants enrolled; chemotherapy allowed; follow-ups at 6 and 12 weeks; four centers involved; ethics approval and trial registration noted.

L-Carnitine, 4 g/day, oral, 12 weeks.

L-Carnitine supplementation (4 g/day for 12 weeks) increased BMI by 3.4% ± 1.4% vs −1.5% ± 1.4% in placebo (p<0.05). Body cell mass and body fat improved (p=0.013 and p=0.041). Serum L-Carnitine rose to about 60% above baseline by week 6 (p<0.009). Quality of life showed improvement in cognitive function; adverse events were similar to placebo. After 12 weeks, median survival favored L-Carnitine (519 ± 50 days vs 399 ± 43 days) but not statistically significant; hospital stay shorter (36 ± 4 days vs 41 ± 9 days) not significant. Authors conclude that L-Carnitine may offer clinically relevant benefits in this setting, though data are preliminary and require confirmation.

Small sample size with early termination; underpowered for key endpoints; limited evaluability due to dropouts; dropout reasons included death and deteriorating health; heterogeneity in concomitant chemotherapy; no direct measurement of tumor growth; data unblinded for analysis; limited generalizability.