WCLC 2025 - Posters & ePosters-P1.11.02 Impact of Prophylactic Use of Cardioprotective L-Carnitine on First-Line Chemoimmunotherapy in Advanced NSCLC: A Cohort Study

P1.11.02 Impact of Prophylactic Use of Cardioprotective L-Carnitine on First-Line Chemoimmunotherapy in Advanced NSCLC: A Cohort Study

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This retrospective cohort study evaluated the impact of prophylactic L-carnitine supplementation on outcomes in advanced non-small cell lung cancer (NSCLC) patients receiving first-line chemoimmunotherapy (PD-1 inhibitor plus platinum-based chemotherapy). Conducted at Shengjing Hospital from 2019 to 2024, 223 patients were divided into two groups: 117 received L-carnitine alongside chemoimmunotherapy, and 116 received chemoimmunotherapy alone. Baseline characteristics such as age, sex, smoking status, hypertension, coronary artery disease, and comorbidity indexes were balanced between groups.<br /><br />The primary endpoints assessed included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and safety. After a median follow-up of 17.7 months, no significant differences were observed between the groups. Median PFS was 9.7 months with L-carnitine versus 10.4 months without (hazard ratio [HR] 1.11; p=0.56). Median OS was 41.2 months versus 37.7 months (HR 1.15; p=0.54). ORR was similar at approximately 60%, and 1- and 2-year survival rates showed no statistically significant differences. Subgroup analyses also revealed no benefits in PFS or OS from L-carnitine use.<br /><br />Regarding safety, cardiac-related adverse events and immune-related myocarditis rates were comparable between groups, with no grade 3 myocarditis reported.<br /><br />In conclusion, prophylactic L-carnitine did not confer survival advantages or improved safety profiles in advanced NSCLC patients treated with first-line chemoimmunotherapy. These results suggest routine L-carnitine use in this setting is not supported. The authors recommend further prospective studies to explore any potential roles or identify subgroups that might benefit from L-carnitine supplementation.

Asset Subtitle

Cheng Han

Meta Tag

Speaker Cheng Han

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

L-carnitine supplementation

non-small cell lung cancer

NSCLC

chemoimmunotherapy

PD-1 inhibitor

platinum-based chemotherapy

progression-free survival

overall survival

objective response rate

adverse events