Acetyl-L-Carnitine may help prevent chemo side-effect of peripheral nerve loss, but the proof is still lacking

Researchers led by Mario Campone, M.D. from the Institut de Cancerologie de l’Quest – Rene Gauducheau, Saint Herblain, Nantes, have conducted a double blind, randomised phase II clinical trial to evaluate the efficacy and safety of Acetyl-L-Carnitine in the prevention of  sagopilone-induced peripheral neuropathy.

Sagopilone is a new and fully synthetic epithilone with activity against multi-drug resistant cancer cell lines, and has already shown efficacy in solid tumours such as melanoma and ovarian cancer. It has been clinical trialed with cisplatin in non-small cell lung cancer. Epothilones are a new class of cancer drugs. Like taxanes (paclitaxel, docitaxel), they prevent cancer cells from dividing and they seem to have more effectiveness and less side-effects than taxanes. 

However, one known side-effect is damage to peripheral nerve endings in the body. Researchers believed that previous studies suggested that Acetyl-L-Carnitine might prevent this.

The patients were either ovarian cancer or castration-resistant prostate cancer patients and were given SAG with either the ALC or a placebo. While overall there was no significant difference between the ALC and SAG group, the researchers concluded that in the ovarian cancer group the group taking ALC had less grade 3 and above peripheral nerve damage.

According to the National Cancer Institute, Acetyl-L-carnitine is a mitochondrial metabolite that facilitates the movement of fatty acids into the mitochondria for energy and is also used to generate acetyl coenzyme A. It is often used in conjunction with alpha-Lipoic acid, which is a coenzyme involved in mitochondrial ATP production and its reduced form can recycle other antioxidants.

There is some belief that ALC can provide a benefit in peripheral nerve damage and lessen side-effects. The above research mirrored trials with taxans, where no side-effects were reported and overall not much improvement, although certain cancer markers were improved.

Nov - Dec 2013 Cancer Watch
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