Evaluation of the cardioprotective effect of l-carnitine and silymarin in cancer patients receiving anthracycline-containing chemotherapy

Abstract

Background: Anthracycline-induced cardiotoxicity is the most common constraint of its use in the treatment of various types of cancer. This study aimed to investigate the benefits of adding L-carnitine and silymarin compared to anthracycline chemotherapy alone in patients with cancer. Method(s): 83 patients were recruited from the Clinical Oncology Department, Tanta University, Egypt, and prospectively randomized to receive their anthracycline-containing therapeutic regimen, control group (n=33), anthracycline plus L-carnitine, L-carnitine group (n=25), or anthracycline plus silymarin, silymarin group (n= 25). Blood samples were collected at begging and after 6 months to measure LDH, CK-MB, cTn I, Anticardiolipin IgG, Fe, ferritin, and TIBC, and % of saturation. % EF was documented. Data were statistically analyzed by ANOVA and paired t-test. P <0.05 was statistically significant. Result(s): The obtained data suggested that adding L-carnitine to anthracycline chemotherapy had a significant beneficial effect on %EF (p=0.003), anticardiolipin IgG (P=0.000), ferritin (P=0.000), and TIBC(P=0.011), and that adding silymarin to anthracycline chemotherapy had a significantly beneficial effect on anticardiolipin IgG (P=0.000), iron (p=0.001),ferritin (p= 0.000), TIBC (p=0.007), and % saturation (p=0.001) silymarin group showed a significant decrease in iron profile compared to the L-carnitine group, supporting the hypothesis of silymarin iron chelating activity. Conclusion(s): The co-administration of L-carnitine or silymarin with anthracycline-containing chemotherapy represents a new therapeutic strategy, especially silymarin, for better control of anthracycline-induced cardiotoxicity, as silymarin resulted in more beneficial effects on iron profile compared to anthracycline alone and anthracycline with L-carnitine. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest.Copyright © 2020