Back to Search
Start Over
Carnitine insufficiency is associated with fatigue during lenvatinib treatment in patients with hepatocellular carcinoma
- Source :
- PLoS ONE, PLoS ONE, Vol 15, Iss 3, p e0229772 (2020)
- Publication Year :
- 2020
- Publisher :
- Public Library of Science (PLoS), 2020.
-
Abstract
- Background Fatigue is a common adverse event during lenvatinib treatment in patients with hepatocellular carcinoma. One mechanism contributing to development of fatigue might involve abnormal adenosine triphosphate synthesis that is caused by carnitine deficiency. To address this possibility, we examined the relationship between carnitine levels and fatigue during lenvatinib treatment. Methods This prospective study evaluated 20 patients with hepatocellular carcinoma who underwent lenvatinib treatment. Both blood and urine samples were collected from the patients before starting lenvatinib therapy (day 0), and on days 3, 7, 14, and 28 thereafter. Plasma and urine concentrations of free and acyl carnitine (AC) were assessed at each time point. The changes in daily fatigue were evaluated using the Brief Fatigue Inventory (BFI). Results Plasma levels of free carnitine (FC) at days 3 and 7 were significantly higher compared with baseline (p = 0.005, p = 0.005, respectively). The urine FC level at day 3 was significantly higher compared with baseline (p = 0.030) and that of day 7 tended to be higher compared with baseline (p = 0.057). The plasma AC concentration at days 14 and 28 was significantly higher compared with that of baseline (p = 0.002, p = 0.005, respectively). The plasma AC-to-FC (AC/FC) ratio on days 14 and 28 was significantly higher compared with baseline (p = 0.001, p = 0.003, respectively). There were significant correlations between the plasma AC/FC ratio and the change in the BFI score at days 14 and 28 (r = 0.461, p = 0.041; r = 0.770, p = 0.002, respectively). Conclusions Longitudinal assessments of carnitine and fatigue in patients with hepatocellular carcinoma suggest that lenvatinib affects the carnitine system in patients undergoing lenvatinib therapy and that carnitine insufficiency increases fatigue. The occurrence of carnitine insufficiency may be a common cause of fatigue during the treatment.
- Subjects :
- Male
0301 basic medicine
Physiology
Cancer Treatment
Urine
Pathology and Laboratory Medicine
Gastroenterology
chemistry.chemical_compound
0302 clinical medicine
Blood plasma
Medicine and Health Sciences
Hyperammonemia
Oral Administration
Longitudinal Studies
Prospective Studies
Prospective cohort study
Fatigue
Routes of Administration
Aged, 80 and over
Multidisciplinary
Pharmaceutics
Liver Diseases
Liver Neoplasms
Middle Aged
Body Fluids
Treatment Outcome
Blood
Oncology
Research Design
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Quinolines
Medicine
Female
Anatomy
Cardiomyopathies
Lenvatinib
Research Article
medicine.drug
medicine.medical_specialty
Carcinoma, Hepatocellular
Drug Administration
Clinical Research Design
Science
Gastroenterology and Hepatology
Research and Analysis Methods
Carcinomas
Blood Plasma
03 medical and health sciences
Signs and Symptoms
Muscular Diseases
Drug Therapy
Diagnostic Medicine
Carnitine
Internal medicine
Gastrointestinal Tumors
medicine
Carcinoma
Humans
Adverse effect
Aged
Pharmacology
business.industry
Phenylurea Compounds
Biology and Life Sciences
Cancers and Neoplasms
Hepatocellular Carcinoma
medicine.disease
030104 developmental biology
chemistry
Dietary Supplements
Adverse Events
business
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....02c639294b0232e8d0cb240ce8c9e26e