Author of

• 14704

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  P2.11 - Poster Session/ Palliative and Supportive Care (ID 230)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Palliative and Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 14705

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    P2.11-001 - The Relationship between Carnitine Pharmacokinetics and Fatigue in Thoracic Cancer Patients Treated with Cisplatin-Containing Chemotherapy (ID 2810)

    09:30 - 09:30  |  Author(s): T. Miwa
    • Abstract

    Background:
    A large majority of patients who receive chemotherapy suffer from fatigue, which lowers their QOL and activities and also has a negative influence on therapeutic efficacy. Although supportive care for those undergoing chemotherapy has steadily progressed, the pathogenesis and treatment of fatigue during chemotherapy is still unknown. Carnitine is an amino acid with a molecular weight of 161, and it plays a critical role in energy production. A decreased level of plasma carnitine has been reported in the case of cancer patients who developed cachexia. It has been reported that carnitine is excreted in the urine after the administration of platinum-type anticancer drugs. We examined the relationship between carnitine pharmacokinetics in patients who received chemotherapy including cisplatin (CDDP) and fatigue.
    
    Methods:
    Ten patients (7 male/3 female, median age 66.5 yrs (46-73), 3 SCLC/4 NSCLC/3 malignant mesothelioma, 6 PS0/4 PS1) who received standard chemotherapy including CDDP were examined. We performed 24-hour urine collection and took blood samples on day 1 (before the administration of chemotherapy), day 2, 3, 4, and 8 to measure free carnitine concentration, total carnitine concentration, and acylcarnitine concentration in the plasma and urine. We simultaneously evaluated fatigue levels using the CTCAE, STAT Japanese version, and “Functional Assessment of Chronic Illness Therapy-Fatigue” (FACIT-F).
    
    Results:
    The total carnitine concentration in the plasma samples was the highest after 48 hours (day3) of administration and showed significant increase compared to before the administration of CDDP (day1)(65.3±17.6 µmol/L vs. 95.2±28.9 µmol/L, p=0.001). Total urine carnitine concentration was the highest after 24 hours (day2) of administration and showed significant increase compared to day1 (122.3±108.7 µmol/L vs. 632.9±376.6 µmol/L, p=0.003). Fatigue levels were the most severe on day 4 and did not improve thereafter.
    
    Conclusion:
    The study suggests an increase of the amount of carnitine excretion within urine is a possible predictive factor for the appearance of fatigue related to chemotherapy. Future studies will be planned to investigate the protective effects of carnitine administration for fatigue in patients treated with CDDP-containing chemotherapy.