Acetyl-L-Carnitine (ALCAR) for Stage IV Cancer
Also known as: ALCAR, ALC, Levacecarnine
ALCAR may reduce chemotherapy-induced peripheral neuropathy — a dose-limiting side effect of many cancer treatments.
Mechanism of Action
ALCAR supports mitochondrial function in peripheral neurons damaged by chemotherapy agents (cisplatin, taxanes, vincristine). It enhances nerve regeneration, reduces oxidative damage to Schwann cells, and modulates inflammatory cytokines in the peripheral nervous system.
General mechanism: Acetylated amino acid derivative. Mitochondrial fatty acid transport, acetyl group donor for acetylcholine synthesis, neurotrophic factor enhancer.
Current Evidence
Multiple trials for chemotherapy-induced neuropathy show mixed results. Some evidence of prevention when given concurrently with chemotherapy. Benefit may vary by chemotherapy agent.
Clinical Status: Phase II/III for chemotherapy-induced neuropathy. Mixed results.
Safety Profile
Very safe. GI effects possible. May increase seizure frequency in susceptible individuals. Fishy body odor at high doses.
Key Research Questions
- Which chemotherapy agents benefit most from concurrent ALCAR?
- Does ALCAR interfere with anti-tumor efficacy of platinum-based chemotherapy?